Epstein-Barr Virus Uveitis Confirmed via Aqueous Humor Polymerase Chain Reaction and Metagenomics-A Case Report

被引：0

作者：

Hsia, Ning-Yi ^{[1
,2
]}

Bair, Henry ^{[1
,3
]}

Lin, Chih-Ying ^{[1
]}

Lin, Chun-Ju ^{[1
,2
,4
]}

Lai, Chun-Ting ^{[1
,2
]}

Chang, Chieh-Min ^{[5
]}

Lin, Jane-Ming ^{[1
]}

Tsai, Yi-Yu ^{[1
,2
,4
]}

机构：

[1] China Med Univ, China Med Univ Hosp, Dept Ophthalmol, Taichung 40402, Taiwan

[2] Asia Univ, Dept Optometry, Taichung 40447, Taiwan

[3] Stanford Univ, Byers Eye Inst, Sch Med, Stanford, CA 94303 USA

[4] China Med Univ, Coll Med, Sch Med, Taichung 404327, Taiwan

[5] China Med Univ, Precis Med Ctr, Taichung 404327, Taiwan

来源：

MEDICINA-LITHUANIA | 2024年 / 60卷 / 01期

关键词：

Epstein-Barr virus; polymerase chain reaction; metagenomics; uveitis;

D O I：

10.3390/medicina60010097

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

This is a case report of Epstein-Barr virus (EBV) uveitis confirmed via aqueous humor polymerase chain reaction (PCR) and metagenomics. This 72-year-old male with a history of diabetes and herpes zoster complained of redness and blurred vision in his right eye for eight months. Mild conjunctival injection, anterior chamber cells, mutton-fat keratic precipitates, and vitreous haze were noted. Fluorescein angiography revealed dye leakage from retinal vessels without retinal ischemic changes. Only the serum anti-cytomegalovirus (CMV) IgG was positive while the aqueous humor PCR for VZV (Varicella-zoster virus), HSV (Herpes simplex viruses), CMV, and EBV was initially negative. Inflammation recurred and vitreous haze worsened after discontinuing nine-month topical ganciclovir and oral prednisolone. the aqueous humor PCR was repeated due to persistent low-grade inflammation. The EBV PCR turned out to be positive. Shotgun metagenomics revealed 1459 classified sequences (1.62%) and confirmed the EBV infection. Topical ganciclovir and methylprednisolone treatment was resumed. Conjunctival injection improved while pigmented keratic precipitates lessened. Elderly patients with diabetes or under immunosuppression may be susceptible to chronic uveitis associated with subsequent EBV infection. Repeated aqueous humor PCR and shotgun metagenomics are important tools in the diagnosis of this case of chronic indolent panuveitis.

引用

页数：6

共 12 条

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