Journal of Ophthalmic Inflammation and Infection最新文献

{"title":"Culture-proven endophthalmitis associated with Boston Type I keratoprosthesis: clinical features, microbiologic aspects, and outcomes.","authors":"Charles Zhang, Mariam Tadross, Michael M Massengill, Guillermo Amescua, Victor L Perez, Harry W Flynn","doi":"10.1186/s12348-025-00559-6","DOIUrl":"10.1186/s12348-025-00559-6","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize the clinical presentation, management, and outcomes of culture-proven endophthalmitis associated with the surgical use of a Boston Type I keratoprosthesis (Boston I KPro).</p><p><strong>Methods: </strong>A retrospective consecutive case series was conducted of culture-positive cases of endophthalmitis associated with the surgical use of Boston I KPro at a single tertiary referral center. Data were collected on patient demographics, transplant history, presenting features, management strategies, and outcomes.</p><p><strong>Results: </strong>Inclusion criteria were met by 9 eyes of 9 patients. The mean age was 76 ± 3 years. At presentation, all eyes were on chronic topical antibiotic prophylaxis. Initial vision was hand motion or worse in 8/9 (89%) of eyes. Presumed etiologies included early postoperative infection in 3/10 (30%), corneal melt with leaks in 3/10 (30%), corneal ulcer without leaks in 3/10 (30%). Vitreous cultures identified gram-positive organisms in 7/9 (78%), including Staphylococcus aureus in 3, Streptococcus sp. in 3, coagulative-negative Staphylococcus in 1, Corynebacterium in 1 and Mycobacterium in 1. Vitrectomy was performed in 8/9 (89%) of eyes with 3 eyes undergoing removal of the Boston I KPro. Despite prompt treatment, visual outcomes were poor with best-corrected visual acuity at last follow-up averaging 20/1600 with 2 eyes achieving ≥ 20/200 vision. Enucleation or evisceration was performed in 2 eyes.</p><p><strong>Conclusions: </strong>Culture-proven endophthalmitis after Boston I KPro implantation is a rare, devastating complication. Patients present rapidly with severe vision loss. Management often includes prompt vitrectomy. Visual prognosis is guarded with most eyes having worse than 20/200 vision at last follow-up.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of risk factors and different therapeutic options for ocular toxoplasmosis recurrence: a retrospective study.","authors":"Clara Rizzo, Rocco Micciolo, Daniela Bacherini, Fabrizio Giansanti, Erika Bonacci, Giorgio Marchini, Emilio Pedrotti, Francesca Bosello","doi":"10.1186/s12348-026-00578-x","DOIUrl":"10.1186/s12348-026-00578-x","url":null,"abstract":"<p><strong>Background: </strong>Ocular toxoplasmosis is a leading cause of vision impairment and is burdened by the risk of recurrence. This study, conducted at the University Hospital of Verona, aimed to identify potential risk factors associated with disease recurrence.</p><p><strong>Main body: </strong>A total of 86 patients were treated for ocular toxoplasmosis between 1996 and 2023, with 43 completing treatment and follow-up of at least 18 months after treatment. Patients were treated with one of two therapeutic options: either trimethoprim-sulfamethoxazole or pyrimethamine-sulfametopyrazine. Over the study period, 21 patients experienced at least one recurrence, with a median time for the first recurrence of approximately six years. The average follow-up duration was eight years, and the probability of recurrence after seven years was 58%. Sleep duration emerged as a significant risk factor, as patients who slept between six and eight hours per night had a lower likelihood of recurrence. No significant associations were found with other factors, including gender, ethnicity, country of birth, education level, smoking, alcohol consumption, age at diagnosis, autoimmune diseases, vitamin deficiencies, vaccinations, cat ownership, consumption of raw or undercooked meat, place of residence, occupational soil exposure, primary infection (IgM positive), or the affected eye's laterality. Moderate evidence suggested a potential link between recurrences and psychological factors, such as stressful life events, lesion location, and pregnancy following the first diagnosis. Notably, women who experienced pregnancy after diagnosis had a threefold increased risk of recurrence. Regarding visual outcomes, there was modest evidence indicating that patients treated with trimethoprim-sulfamethoxazole achieved better final visual acuity compared to those treated with pyrimethamine. However, this difference was not statistically significant, and the underlying mechanism remains unclear.</p><p><strong>Conclusion: </strong>The findings highlight the potential role of sleep duration in reducing recurrence risk and suggest a possible association between psychological stress, post-diagnosis pregnancy, and recurrence. Additionally, trimethoprim-sulfamethoxazole treatment may contribute to better long-term visual acuity, although further research is needed to confirm these observations.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13369066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147987854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent cytomegalovirus iridocyclitis and vitreoretinal lymphoma in the same eye during long-term infliximab therapy: a case report.","authors":"Hitoshi Goto, Shiho Kunimatsu-Sanuki, Ryota Suga, Junko Hori","doi":"10.1186/s12348-026-00594-x","DOIUrl":"10.1186/s12348-026-00594-x","url":null,"abstract":"<p><strong>Background: </strong>We report a rare case of cytomegalovirus (CMV) iridocyclitis and vitreoretinal lymphoma (VRL) that developed sequentially in the same eye during long-term infliximab (IFX) therapy for ulcerative colitis. This case highlights both the risk of opportunistic ocular infections and lymphoproliferative disorders coexisting in the same eye and the diagnostic challenges associated with prolonged immunosuppression.</p><p><strong>Case presentation: </strong>A 65-year-old man presented to the ocular inflammatory service at Nippon Medical School Tama-Nagayama Hospital with deteriorating vision in the left eye. His medical history included IFX therapy for 11 years for ulcerative colitis, a 7-year history of bilateral primary open-angle glaucoma, and recurrent iridocyclitis in the left eye. Slit-lamp examination revealed mutton-fat keratic precipitates and dense vitreous opacities. Multiplex PCR of the aqueous humor detected CMV and Epstein-Barr virus (EBV). The cytological grading of the vitreous fluid was class IIIb. Cytokine analysis revealed an interleukin (IL)-10/IL-6 ratio of > 1.0, and immunoglobulin heavy chain gene rearrangement revealed monoclonality. Based on these findings, the patient was diagnosed with concurrent CMV iridocyclitis and VRL in the same eye. EBV positivity in the aqueous humor may have been associated with VRL development under prolonged immunosuppression. Topical ganciclovir was initiated for CMV iridocyclitis. The patient underwent bilateral ocular radiotherapy (40 Gy) and systemic chemotherapy with rituximab, methotrexate, procarbazine, and vincristine after IFX cessation. Although inflammatory and infiltrative lesions resolved, his final visual acuity was 20/200 due to glaucomatous visual field loss.</p><p><strong>Conclusions: </strong>The present case highlights both the risk of opportunistic ocular infections and lymphoproliferative disorders associated with prolonged immunosuppression and the diagnostic challenge when both conditions coexist in the same eye. Careful monitoring and close collaboration between ophthalmologists and internists are essential for the early diagnosis and appropriate management of such patients.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13342007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of thermal imaging in orbital inflammation disorders.","authors":"Clément Rocchi, Stephanie Telo, Nicolas Chevalier, Nathalie Tieulie, Lydiane Mondot, Albert Themelin, Stephanie Baillif, Arnaud Martel","doi":"10.1186/s12348-026-00577-y","DOIUrl":"10.1186/s12348-026-00577-y","url":null,"abstract":"<p><strong>Background/aims: </strong>Assessing periocular inflammation is essential in several disorders, including Thyroid Eye Disease (TED). The Clinical Activity Score (CAS) is the most commonly used method to assess orbital inflammation, but is associated with significant inter-observer variability. The aim of this study was to assess the ability of Infrared Thermography (IRT) to detect orbital inflammation in TED and other orbital inflammation disorders (OOID).</p><p><strong>Methods: </strong>A retrospective study was conducted between March 2020 and November 2023. Patients were divided into four groups: active TED (CAS ≥ 3), non-active TED (CAS < 3), OOID, and healthy controls. Demographics, proptosis, and CAS were recorded. IRT was performed in 6 periocular areas, including the caruncle. Four IRT periocular patterns were characterized.</p><p><strong>Results: </strong>Hundred and ten patients (63.64% of women) with a mean age of 59.47 (25-93) years were included. Thirteen (11.82%) patients were included in the active TED group, 44 (40.00%) in the non-active TED group, 17 (15.45%) in the OOID group and 36 (32.73%) in the control group. Non-active TED and control patients had lower mean caruncular and periocular temperatures compared to active TED and OOID patients (p < 0.05). The caruncular temperature was significantly higher in active TED patients compared to OOID patients (p < 0.05). Non-active TED and control patients mainly showed round and upper coma IRT patterns while active TED and OOID patients showed crab claw and other IRT patterns (p < 0.05).</p><p><strong>Conclusion: </strong>Periocular IRT measurement is a rapid, simple, non-invasive, cost-effective, and reproducible method for detecting orbital inflammation and allows differentiating active TED from OOID.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147930374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periorbital necrotizing soft tissue infection due to Streptococcus pyogenes with streptococcal toxic shock syndrome: successful early structured multidisciplinary management.","authors":"Shigeko Yashiro, Kento Inoue, Yuki Kitagawa, Kei Yamamoto, Masako Nagahara, Phung Vu, Mugen Ujiie, Miyuki Nagahara, Norio Ohmagari","doi":"10.1186/s12348-026-00589-8","DOIUrl":"10.1186/s12348-026-00589-8","url":null,"abstract":"<p><p>Periorbital necrotizing soft tissue infections (NSTIs) are rare but potentially life-threatening, particularly when complicated by streptococcal toxic shock syndrome (STSS). Rapid systemic deterioration can occur, even in previously healthy individuals. We report a case of a 57-year-old woman who developed periorbital NSTI, complicated by STSS, secondary to Streptococcus pyogenes. Emergency eyelid debridement was performed within 24 h of symptom onset, followed by intensive care management and empirical broad-spectrum intravenous antibiotics, which were subsequently adjusted to pathogen-directed therapy. Localized recurrence on hospital day 6 was treated with repeated, limited debridement and adjunctive, low-concentration antiseptic irrigation. The patient recovered from the STSS. Progressive black necrosis did not occur; visual function was preserved, reconstructive surgery was unnecessary, and complete cosmetic recovery was achieved within eight months. This case underscores that STSS may develop rapidly, even in healthy individuals, and highlights the importance of early, structured, and multidisciplinary management.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13333583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative long-term outcomes of conventional immunomodulatory therapy, biologic agents, and combination therapy in chronic uveitis.","authors":"Charles Zhang, Matthew McSoley, Sinan Ersan, Steven Yeh, Thomas A Albini","doi":"10.1186/s12348-026-00591-0","DOIUrl":"10.1186/s12348-026-00591-0","url":null,"abstract":"<p><strong>Background: </strong>Chronic non-infectious uveitis can lead to vision loss if not adequately controlled. Thus, steroid-sparing immunomodulatory therapy (IMT) is often required to achieve and maintain disease quiescence. It is unclear if biologic agents inhibiting tumor necrosis factor alpha (TNF-α) provide superior control of chronic uveitis compared to conventional IMTs on their own or as combination therapy.</p><p><strong>Methods: </strong>This is a multicenter retrospective cohort study using the TriNetX US Collaborate network. Adult patients (≥18 years) with chronic non-infectious uveitis who achieved steroid-sparing quiescence on IMT were included. Patients were grouped by initial maintenance with conventional IMT (methotrexate, mycophenolate mofetil, or azathioprine), biologic TNF-α inhibitor (adalimumab or infliximab) or combination therapy (both conventional IMT and biologic agent), and the incidence of flares over 6, 12, 18 and 24 months of follow-up were analyzed. Outcomes were compared between groups using paired chi-squared tests on propensity score matched cohorts with relative risk (RR) and 95% confidence intervals calculated for each outcome.</p><p><strong>Results: </strong>A total of 2,912 patients on conventional IMT, 736 patients on biologic therapy and 1,313 on combination therapy met the definition of steroid-sparing control. Patients on combination therapy had significantly lower rates of flares as compared to those on conventional IMT at 6 months (RR 0.53; p = 0.0070), 12 months (RR 0.52; p = 0.0011), 18 months (RR 0.56; p = 0.0022) and 24 months (RR 0.56; p = 0.0012). No difference in the rate of flares was found between combination versus biologic therapy, or conventional IMT versus biologic therapy at 6-, 12-, 18- and 24 months. Patients initially treated with conventional IMT had higher rates of augmentation or switching to biologic therapy at 12 months (RR 1.74; p = 0.0386), 18 months (RR 1.65; p = 0.0219) and 24 months (RR 1.65; p = 0.0114).</p><p><strong>Conclusion: </strong>The current study indicates that for patients with chronic uveitis who achieve steroid-sparing control on IMT, those treated with a combination of a conventional IMT and a biologic TNF-α inhibitor have a lower risk of disease activation as compared to those on conventional IMT.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Secondary punctate inner choroidopathy in an RP2 associated retinopathy female carrier.","authors":"Gonzalo Roig-Ferreruela, Sofía Uncetabarrenechea-Larrucea, María Aramberri-Araiz, Sonia Valsero-Franco, Joseba Artaraz, Ester Carreño, Alex Fonollosa","doi":"10.1186/s12348-026-00590-1","DOIUrl":"10.1186/s12348-026-00590-1","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a case of punctate inner choroidopathy (PIC) occurring in a RP2 associated Retinopathy female carrier, highlighting the diagnostic contribution of multimodal imaging and the therapeutic course.</p><p><strong>Methods: </strong>Observational case report with multimodal retinal imaging, electrophysiology, and genetic testing.</p><p><strong>Results: </strong>A 46-year-old woman with high myopia (- 8 diopters in both eyes) and a right Adie's pupil presented with a shadow-like visual disturbance in the right eye (RE). Family history was notable for X-linked retinitis pigmentosa: her brother was hemizygous for the pathogenic RP2 variant c.1 A > G (p.Met1?), and her mother was a heterozygous carrier with light perception vision in both eyes. At presentation, best-corrected visual acuity (BCVA) was 20/32 in the RE and 20/20 in the left eye (LE). Fundus examination revealed diffuse chorioretinal atrophy and multiple punched-out lesions, predominantly nasal, with some macular involvement suggestive of inactive PIC. Subtle peripheral bone spicules were also observed. Fundus autofluorescence (FAF) demonstrated hypoautofluorescent lesions corresponding to the punched-out scars and radial hyperautofluorescent streaks around the posterior pole, a characteristic pattern of X-linked RP carriers. Flash electroretinography revealed bilateral rod and cone dysfunction, more pronounced in the LE. Genetic testing confirmed the heterozygous RP2 c.1 A > G variant, establishing the patient as an X-linked RP carrier. Two years later, the patient developed a new greyish inflammatory lesion in the papillomacular bundle of the RE. OCT demonstrated hyperreflective subretinal material disrupting the RPE with posterior hypertransmission, consistent with an acute PIC lesion. She was treated with systemic corticosteroids and methotrexate. Subsequent flares required treatment escalation, including mycophenolate mofetil and later a combination of methotrexate and adalimumab due to intolerance. One year after initiating biologic therapy, the patient remains in remission with stable visual acuity (20/32 RE, 20/25 LE).</p><p><strong>Conclusions: </strong>Secondary PIC may occur in carriers of X-linked RP. Multimodal imaging and genetic testing are essential for accurate characterization, and immunosuppressive therapy can achieve sustained disease control.</p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultra-widefield retinal imaging for early detection of asymptomatic cytomegalovirus retinitis after allogeneic hematopoietic stem cell transplantation: a prospective pilot feasibility study.","authors":"Aina Moll-Udina, Alexandra Pedraza, Lucia Miguel-Escuder, Maria Suárez-Lledó, Javier Nogués-Castell, Francesc Fernández Avilés, María Borrell Balagué, Mireia Hereu de Batlle, Montserrat Morató Vilaseca, Juan Pablo Figueroa-Vercellino, Víctor Llorenç, Alfredo Adán","doi":"10.1186/s12348-026-00585-y","DOIUrl":"10.1186/s12348-026-00585-y","url":null,"abstract":"<p><p>BACKGROUND: To evaluate the feasibility and potential clinical utility of ultra-widefield (UWF) retinal imaging as a screening strategy for the early detection of asymptomatic cytomegalovirus retinitis (CMVR) in patients with systemic cytomegalovirus (CMV) viremia after allogeneic hematopoietic stem cell transplantation (alloHSCT). METHODS: This prospective, single-center pilot study included adult alloHSCT recipients with documented CMV replication within the previous 12 months and no ocular symptoms. Patients underwent UWF retinal imaging (Optomap®) at the time of CMV detection and during follow-up. Demographic, hematologic, immunologic, and virologic data were collected. Retinal images were assessed by a uveitis specialist, and patients with suspected retinal involvement underwent targeted ophthalmologic evaluation and treatment. RESULTS: Thirty-nine alloHSCT recipients (mean age 48.8 years; 51.3% male) were screened using UWF imaging. CMVR was identified in one asymptomatic patient (2.6%), presenting with peripheral retinal periphlebitis and hemorrhages 251 days after alloHSCT. Notably, CMV PCR in peripheral blood was negative at the time of retinal diagnosis, while aqueous humor PCR confirmed CMV infection. Early detection through UWF imaging enabled prompt systemic antiviral therapy, resulting in complete resolution of retinal lesions and preservation of visual acuity. CONCLUSIONS: In this prospective pilot study, UWF retinal imaging proved to be a feasible, non-invasive approach for screening asymptomatic alloHSCT recipients with prior CMV replication. Although the incidence of CMVR was low, UWF imaging allowed detection of early peripheral retinal involvement that would likely have been missed by symptom-based surveillance or blood PCR monitoring alone. These findings support the potential role of targeted UWF screening in selected high-risk patients and justify further evaluation in larger, multicenter prospective studies. </p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13265437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral visual impairment caused by Toxoplasma gondii encephalitis and ocular GVHD in a patient after allo-HSCT.","authors":"Armin Taghavi Eraghi, Uwe Pleyer, Tina Dietrich-Ntoukas","doi":"10.1186/s12348-026-00582-1","DOIUrl":"10.1186/s12348-026-00582-1","url":null,"abstract":"<p><p>BACKGROUND: Cerebral toxoplasmosis is a rare but potentially fatal opportunistic infection in non-HIV immunocompromised patients, particularly after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Diagnosis is often delayed due to nonspecific clinical manifestations. CASE PRESENTATION: We report a 66-year-old man with myelodysplastic syndrome that had transformed into secondary acute myeloid leukemia. Following remission induction with CPX-351, he underwent allo-HSCT and received ciclosporin A, mycophenolate mofetil, and corticosteroids for graft-versus-host disease prophylaxis. Standard cotrimoxazole prophylaxis was withheld because of hepatic intolerance and thrombocytopenia, and inhaled pentamidine was administered instead. Three months post-transplant, the patient presented with bilateral visual field deficits. Automated perimetry revealed a homonymous inferior quadrantanopia. Brain MRI demonstrated a solitary ring-enhancing lesion in the left optic radiation, and cerebrospinal fluid PCR confirmed Toxoplasma gondii. Treatment with sulfadiazine, pyrimethamine, and folinic acid was initiated, followed by long-term secondary prophylaxis. Despite residual visual impairment, the patient achieved clinical stability. CONCLUSION: This case underscores the diagnostic value of neuro-ophthalmologic examination and early neuroimaging in detecting opportunistic CNS infections. It also highlights the challenges of prophylactic decision-making in immunocompromised patients when cotrimoxazole is contraindicated. Individualized immunosuppressive and prophylactic strategies, along with multidisciplinary care, were key to successful management. </p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":"16 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contribution of 16S rRNA gene PCR to microbiological diagnosis of endophthalmitis: a retrospective clinical cohort study of 71 vitreous and aqueous humor samples.","authors":"Paul Robert, Sylvain Meyer, Fabien Garnier, Marie-Cécile Ploy, Pierre-Yves Robert, Maxime Rocher","doi":"10.1186/s12348-026-00581-2","DOIUrl":"10.1186/s12348-026-00581-2","url":null,"abstract":"<p><p>BACKGROUND: Culture remains the reference method for microbiological diagnosis of endophthalmitis, but its sensitivity is limited by small sample volumes, prior antibiotics, and fastidious organisms. This study evaluates the diagnostic contribution of 16S rRNA gene-targeted polymerase chain reaction (PCR) in improving bacterial identification in patients with endophthalmitis, compared to conventional culture. METHODS: We conducted a retrospective cohort study including patients diagnosed with endophthalmitis and managed at Limoges University Hospital (France) from January 2018 to December 2024. Aqueous and/or vitreous samples were analyzed using both conventional culture and broad-range PCR targeting the bacterial 16S rRNA gene. The primary outcome was the global identification rate of pathogens by each method and their combination. Subgroup analyses considered the type of ocular sample. RESULTS: Seventy-one intraocular samples from 50 episodes were analyzed (41 aqueous humor, 30 vitreous). Culture allowed bacterial identification in 21.1% of cases (15/71), compared to 39.4% for PCR (28/71, p = 0.002). The approach combining culture and PCR reached 42.3% (30/71, p < 0.001). Notably, PCR was positive in 26.8% of culture-negative cases (15/56), providing additional identification. Vitreous samples yielded higher identification rates than aqueous samples for both cultures (36,7% vs. 9,8%) and PCR (56,7% vs. 26,8%). CONCLUSIONS: PCR targeting the 16S rRNA gene significantly increases the diagnostic and the microbiological yield of intraocular sampling in endophthalmitis, particularly in culture-negative cases and in vitreous specimens. These findings support the complementary role of PCR in the microbiological workup of endophthalmitis. </p>","PeriodicalId":16600,"journal":{"name":"Journal of Ophthalmic Inflammation and Infection","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13247020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}