Tenorio G, Rivas-Sánchez B, Velasco-Castrejón Ó

Language: Spanish
References: 37
Page: 135-143
PDF size: 113.01 Kb.

ABSTRACT

Antecedents: Toxoplasmosis is a frequent cause of posterior uveitis shown as focal retinochoroiditis with vitreitis, in most cases the diagnosis and treatment are clinical. Leptospirosis is a cosmopolitan zoonosis affecting people who were exposed to Leptospira interrogans transmited by direct contact in the skin and mucous membrane or indirectly from water and contaminated food with animal urine, ponds, watering areas and unhealthful urban zones mainly after floods. Uveitis can be produced in the eye with the presence of leptospira, even years after infection has occurred. Goal: Taking in consideration that positive titration of serie antibodies antitoxoplasma in patients with uveitis suspecting toxoplasmosis, there is interest to look for other causes provoking such uveitis. Material and method: By means of the microagglutination test in dry plate (MAT), the prevalence of serie antibodies to Leptospira interrogans was determined as well as its serovarieties in patients with clinical diagnosis of ocular toxoplasmosis. It is and observational, comparative open, transversal and prospective study. 26 patients (28 eyes) were included with clinical diagnosis of retinochoroiditis compatible to ocular toxoplasmosis; complete ophthalmologic exploration was done with serum ELISA test for toxoplasmosis. To leptospirosis it was done microaglutination test in dry plate (MAT). The ophthalmologic clinical data were compared type of uveitis and antibodies determination. Results: Uveitis granulomatose was diagnosed in 35.7% of the cases. The inflammatory reaction in the vitreus was predominant (71.4%) and the chorioretinitis focus (42.3%) besides retinal vasculitis (21.4%) and papilitis (14.3%). Visual fineness improved in most of the cases 17/21 which were followed during 3 months. The MAT for leptospirosis was positive in 73% of the patients and the ELISA test was positive to toxoplasmosis in IgG in 38.5%. Conclusions: In patients with clinical diagnosis of toxoplasmosis it was most frequent the positive titration to MAT for leptospirosis than to ELISA for toxoplasmosis. In order to stablish the confiability of the results, specific tests should be done in the eyes as for instance the antibodies titration in the aqueous humor, so the serological determination keeps being controversial.

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