Unilateral uveitic congenital cataract caused by Spiroplasma ixodetis

Congenital cataract and uveitis caused by Spiroplasma ixodetis are rare, with only a small number of cases reported worldwide. We report 2 infants with unilateral uveitic congenital cataracts. Both underwent lensectomy and anterior vitrectomy, received intracameral antibiotics, and were postoperatively treated with a topical corticosteroid-antibiotic regimen. Routine microbiological tests were negative, but 16S rRNA PCR detected S. ixodetis in the vitreous and lens. Identification was confirmed by partial sequencing of the Mollicutes 16S-23S rRNA intergenic spacer region and a species-specific real-time PCR targeting rpoB gene of S. ixodetis. Targeted assays for S. ixodetis can be incorporated into the diagnostic work-up of neonatal uveitic congenital cataract. Recognizing this rare etiology can help optimize antimicrobial therapy and supports further studies of the clinical significance of S. ixodetis.