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Darkfield microscopic (DFM) and serologic evidences for leptospiral infection in panuveitis cases
S Chandrasekaran1, S Krishnaveni, N Chandrasekaran
1Institute of Microbiology, Madurai Medical College.
Abstract:
186 out of 226 (82%) panuveitis cases showed the presence of leptospira in their blood samples by dark field microscopy. 75% cases were found positive for leptospira after low speed centrifugation and an additional 7% became positive after high speed centrifugation. Leptospirosis was four times more common in males than in females. The disease was more prevalent in the age group of 15 to 54 years. MAT was performed in 23 cases of which 9 were positive. ELISA was performed in 20 cases of which 9 were positive. DFM was positive in 19 out of these 23 cases. MAT, ELISA and DFM were positive in six cases. Highest antibody titre was found due to L. autumalis alone in two cases, L. autumnalis, and L. pomona in one case, L. bharathy in one case, L. lanka alone in one case and L. pomona one in one case. DFM was found to be more sensitive in a smal number of cases and hence DFM needs further evaluation by other workers in this field.
Insights
This study found that 82% of panuveitis cases had leptospira in blood samples, with dark field microscopy (DFM) showing high sensitivity. Leptospirosis was more common in males aged 15-54.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Panuveitis, a severe intraocular inflammation, can have infectious origins.
- Leptospirosis is a zoonotic disease caused by pathogenic Leptospira spirochetes.
- Early diagnosis and identification of causative agents are crucial for effective management of panuveitis.
Purpose of the Study:
- To investigate the prevalence of Leptospira in patients diagnosed with panuveitis.
- To evaluate the diagnostic utility of dark field microscopy (DFM) compared to serological tests like Microscopic Agglutination Test (MAT) and Enzyme-Linked Immunosorbent Assay (ELISA).
Main Methods:
- Blood samples from 226 panuveitis patients were examined using dark field microscopy (DFM) with varying centrifugation speeds.
- Serological tests including MAT and ELISA were performed on a subset of patients.
- Positive cases were further analyzed for specific Leptospira serovars.
Main Results:
- Leptospira was detected in 82% of panuveitis cases by DFM.
- Low-speed centrifugation improved detection rates, with high-speed centrifugation identifying an additional 7%.
- Leptospirosis was more prevalent in males (4x) and individuals aged 15-54 years. DFM showed higher sensitivity in a small number of cases compared to MAT and ELISA.
Conclusions:
- Leptospira is a significant, often overlooked, cause of panuveitis.
- Dark field microscopy (DFM) demonstrates high sensitivity for detecting Leptospira in blood samples of panuveitis patients and warrants further investigation.
- The findings highlight the importance of considering leptospirosis in the differential diagnosis of panuveitis, particularly in endemic regions.