Enghelberg Moises, Sierpina David I
Retina Service, Loma Linda University Eye Institute, Loma Linda, USA.
Ophthalmology, Loma Linda University Eye Institute, Loma Linda, USA.
Cureus. 2022 Sep 5;14(9):e28816. doi: 10.7759/cureus.28816. eCollection 2022 Sep.
To describe a unique case highlighting the limitations and caveats of multiplex polymerase chain reaction (mPCR) in the diagnosis of posterior infectious uveitis, specifically frosted branch angiitis (FBA), we present a case of FBA in which multiple diagnostic modalities, including mPCR, are inconclusive. A thorough literature review was carried out to discuss the validity of mPCR in the setting of posterior infectious uveitis, the theoretical effect of sample dilution, and to explore a management strategy in these difficult cases. It is known that mPCR has high sensitivity and specificity, with a low false negative rate. However, the rate of false negatives appears to increase in cases of FBA, and when samples are diluted. In such cases we suggest empiric treatment be initiated and targeted towards microorganisms most likely to be implicated based on exam and history.
为描述一个独特病例，突出多重聚合酶链反应（mPCR）在诊断后部感染性葡萄膜炎（特别是霜样树枝状视网膜血管炎，FBA）中的局限性和注意事项，我们报告一例FBA病例，其中包括mPCR在内的多种诊断方法均无定论。我们进行了全面的文献综述，以讨论mPCR在后部感染性葡萄膜炎中的有效性、样本稀释的理论影响，并探索这些疑难病例的管理策略。已知mPCR具有高灵敏度和特异性，假阴性率低。然而，在FBA病例以及样本稀释时，假阴性率似乎会增加。在这种情况下，我们建议根据检查和病史开始经验性治疗，并针对最可能涉及的微生物。
