Abstract
Abstract Purpose The etiologic evaluation of uveitis is frequently unsuccessful if only noninvasive methods are used. We conducted a prospective study to evaluate systematic screening for pathogens of uveitis. Methods All patients with uveitis referred to the participating tertiary ophthalmology departments from January 2001 to September 2007 underwent intraocular and serum specimen collection. The standardized protocol for laboratory investigations included universal polymerase chain reaction (PCR)‐based detection of any bacteria and mycoses, specific PCR‐based detection of fastidious (difficult‐to‐grow) bacteria and herpes viruses, and culture of vitreous fluid. Sera were tested for fastidious bacteria. Results Among the 1321 included patients, infection was diagnosed in 147 (11.1%) patients: 78 (53%) were caused by fastidious bacteria that included spirochetes, Bartonella species, intracellular bacteria (Chlamydia species, Rickettsia species, Coxiella burnetii), and Tropheryma whipplei; 18 by herpes viruses; and 9 by fungi. Bartonella quintana, Coxiella burnetii, Paracoccus yeei, Aspergillus oryzae, and Cryptococcus albidus were found to be associated with uveitis for the first time, to our knowledge. Conclusion We recommend applying a 1‐step diagnostic procedure that incorporates intraocular, specific microbial PCR with serum analyses in tertiary centers to determine the etiology of uveitis.
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