Brucellar uveitis: intraocular fluids and biopsy studies.
BACKGROUND
Ocular brucellosis is usually diagnosed by clinical criteria and serological tests. Little is known with regard to the ocular immunology of brucellosis and the use of intraocular diagnostic tests. We report retrospectively the laboratory findings of patients with ocular involvement associated with brucellosis.


METHODS
Patients with uveitis with no evident etiologic diagnosis were evaluated at the Instituto de Medicina Tropical "Alexander von Humboldt" of the Universidad Peruana Cayetano Heredia and the Hospital Nacional Cayetano Heredia. Patients were tested for brucellosis, tuberculosis, syphilis, toxoplasmosis, toxocariasis, and human T-cell lymphotropic virus-1. Blood and intraocular fluid samples were examined. Patients with a diagnosis of brucellar uveitis were selected as cases and patients with a diagnosis of uveitis of other etiology were included as controls. The Goldmann-Witmer coefficient was determined.


RESULTS
Twelve patients with clinical and laboratory findings suggestive of brucellar uveitis were considered as cases. Seven patients with uveitis of other etiology were selected as controls. Four (33.3%) patients with ocular brucellosis had negative ocular agglutinations and eight (66.7%) had positive agglutinations. No control cases had positive agglutinations for Brucella melitensis. The sensitivity of the test was 66.7% and the specificity 100%. Only one patient had a positive culture for B. melitensis in subretinal fluid. The Goldmann-Witmer coefficient was calculated in six cases of brucellosis uveitis and five uveitis controls. It was highly positive in three patients with ocular brucellosis. Tissue samples showed lymphoplasmacytic infiltrates.


CONCLUSIONS
Intraocular serological tests could be used to support the diagnosis of ocular brucellosis.
Rolando
Isaías
I
Hospital Nacional Cayetano Heredia, Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Av. Honorio Delgado 430, Lima 31, Peru.
Vilchez
Gustavo
G
Olarte
Liset
L
Lluncor
Marina
M
Carrillo
Carlos
C
Paris
Mark
M
Guerra
Humberto
H
Gotuzzo
Eduardo
E
D000293:Adolescent; D000328:Adult; D000372:Agglutination Tests; D000907:Antibodies, Bacterial / Q000097:blood*; D001082:Aqueous Humor / Q000276:immunology / Q000382:microbiology; D001706:Biopsy; D017347:Brucella melitensis / Q000276:immunology / Q000302:isolation & purification; D002006:Brucellosis / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged; D010568:Peru; D012680:Sensitivity and Specificity; D014605:Uveitis / Q000175:diagnosis / Q000276:immunology / Q000382:microbiology; D055815:Young Adult
D000907:Antibodies, Bacterial; D007074:Immunoglobulin G