First evidence of an endogenous Spiroplasma sp. infection in humans manifesting as unilateral cataract associated with anterior uveitis in a premature baby.
OBJECTIVE
To elucidate a previously unknown aetiology of rapidly progressive unilateral cataract in a premature baby associated with severe anterior uveitis.


METHODS
The lens and vitreous material were saved as part of a special protocol in a 4-month-old premature baby at the time of pars plana lensectomy with anterior vitrectomy. We performed (1) microbiological cultures to detect viable bacterial and fungal organisms; (2) PCR reaction to viral, bacterial and fungal agents; (3) transmission electron microscopy (TEM). In addition, serological examinations were performed for HSV-1 and -2, CMV, VZV and Mycoplasmainfection.


RESULTS
PCR detected Spiroplasma sp.; TEM confirmed the presence of Spiroplasma within the lens fibres. Serological testing and microbiological cultures of the vitreous and lens were negative.


CONCLUSIONS
Endogenous Spiroplasma infection in a premature baby may manifest as rapidly progressive acquired unilateral cataract with anterior uveitis. Beyond this, Spiroplasma infection has never been reported to occur naturally in vertebrates, although experimentally Spiroplasma mirum produces panophthalmitis associated with cataract in a wide range of rodents and in chicks. In acquired infantile cataract with inflammatory signs, PCR and TEM should be performed in the lensectomy/vitrectomy material to detect infectious agents not evident on routine laboratory and microbiological examinations.
Lorenz
Birgit
B
Department of Paediatric Ophthalmology and Ophthalmogenetics, University of Regensburg, Germany. Birgit.Lorenz@klinik.uni-regensburg.de
Schroeder
Josef
J
Reischl
Udo
U
D001483:Base Sequence; D002386:Cataract / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D002387:Cataract Extraction; D004269:DNA, Bacterial / Q000032:analysis; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D013149:Spiroplasma / Q000235:genetics / Q000302:isolation & purification* / Q000648:ultrastructure; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000382:microbiology* / Q000601:surgery; D014821:Vitrectomy
D004269:DNA, Bacterial