Culture and Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) Proven Mycobacterium Tuberculosis Endophthalmitis: A Case Series.
OBJECTIVE
To report early confirmation of Mycobacterium tuberculosis (MTB) endophthalmitis by detection of 85B mRNA in vitreous by a reverse transcriptase polymerase chain reaction (RT-PCR) technique.


METHODS
Retrospective, interventional case series of 5 patients with MTB endogenous endophthalmitis. Vitreous aspirate was subjected to Ziehl-Neelsen (ZN) staining, BACTEC MicroMGIT culture, RT-PCR targeting the 85B gene, real-time PCR targeting the IS6110 region, and nested PCR targeting the MPB64 gene and IS6110 region. Correlation between detection of MTB RNA, culture positivity, and ZN staining was studied.


RESULTS
Five patients with endophthalmitis with no history of tuberculosis revealed acid-fast bacilli on ZN staining of vitreous. RT-PCR detected 85B RNA within 24 h. Culture for MTB was positive in 3/5 patients after 1 month. None of the eyes recovered any useful vision.


CONCLUSIONS
RT-PCR can detect viable MTB RNA and provide evidence of active infection much earlier than culture.
a Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation , Chennai , India.
Ekta
E
Rishi
a Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation , Chennai , India.
Pukhraj
P
Rishi
b Larsen & Toubro Microbiology Research Centre, Vision Research Foundation , Chennai , Tamil Nadu , India.
K Lily
KL
Therese
b Larsen & Toubro Microbiology Research Centre, Vision Research Foundation , Chennai , Tamil Nadu , India.
Gayathri
G
Ramasubban
c Larsen & Toubro Pathology Department, Vision Research Foundation , Chennai , Tamil Nadu , India.
Jyotirmay
J
Biswas
a Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation , Chennai , India.
Tarun
T
Sharma
a Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation , Chennai , India.
Pramod
P
Bhende
a Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation , Chennai , India.
Pradeep
P
Susvar
d Department of Uveitis, Medical Research Foundation , Chennai , Tamil Nadu , India.
Mamta
M
Agarwal
d Department of Uveitis, Medical Research Foundation , Chennai , Tamil Nadu , India.
Amala Elizabeth
AE
George
a Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation , Chennai , India.
Kushal
K
Delhiwala
a Shri Bhagwan Mahavir Vitreoretinal Services, Medical Research Foundation , Chennai , India.
Vishal Rajan
VR
Sharma
D000217:Acyltransferases / Q000235:genetics; D000328:Adult; D000942:Antigens, Bacterial / Q000235:genetics; D001426:Bacterial Proteins / Q000235:genetics*; D001431:Bacteriological Techniques; D009877:Endophthalmitis / Q000175:diagnosis / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000382:microbiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics* / Q000302:isolation & purification*; D012333:RNA, Messenger / Q000235:genetics; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000382:microbiology*; D014822:Vitreous Body / Q000382:microbiology; D055815:Young Adult
D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C080865:MPB64 protein, Mycobacterium; D012333:RNA, Messenger; D000217:Acyltransferases; C121433:antigen 85B, Mycobacterium tuberculosis
Acid fast bacilli; Mycobacterium tuberculosis; RT-PCR; endophthalmitis; vitrectomy