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Acquired paediatric cataract combined with anterior uveitis and dilated cardiomyopathy associated with endogenous Spiroplasma species infection

Poster Details

First Author: A.Gschlie├čer AUSTRIA

Co Author(s):    E. Moser   T. Neumayer   A. Papp   G. Dorner   E. Stifter        

Abstract Details

Purpose:

To present a case of acquired time-staggered bilateral pediatric cataract, anterior uveitis and dilated cardiomyopathy associated with an infection with Spiroplasma species. Spiroplasma is a genus of wall-less small Gram-positive bacteria within the bacterial class of Mollicutes which normally colonizes plants and insects but has also been experimentally proven to propagate in rodents and to cause cataract in suckling mice. In recent literature cases of Spiroplasma infections in humans have been reported and a possible association with cataract and eye inflammation has been drawn.

Setting:

Medical University of Vienna, Austria

Methods:

A three-month-old infant presented with dense unilateral cataract combined with anterior uveitis on the left eye. At first presentation the fellow eye showed no pathological findings. Unilateral lensectomy with anterior vitrectomy was performed. At the age of five months, the infant developed a dilated cardiomyopathy of unknown origin and shortly after anterior uveitis with fibrovascular lens opacification also occurred on the right eye. Routine serologic testing remained negative, however, the initialized empiric systemic antimicrobial treatment with erythromycin improved the eye inflammation as well as the myocardial function. Still, lensectomy with anterior vitrectomy was also necessary on the right eye.

Results:

During surgery of the right eye, samples of native lens material and vitreous body were obtained for eubacterial 16S sequencing PCR, which identified Spiroplasma sp. Postoperatively, the treatment with erythromycin was extended for 3 weeks. The right eye did not show an increased inflammatory response after cataract surgery. The laboratory parameter proBNP reflecting the severity of cardiomyopathy dropped concomitantly.

Conclusions:

Spiroplasma may cause cataract associated with uveitis in infants. In unclear cases of acquired cataract, especially in combination with eye inflammation, we recommend to collect lens tissue samples for PCR sequencing. The present case is also unique because of the association with dilated cardiomyopathy, which responded well to systemic antimicrobial treatment. Consequently, the identification of Spiroplasma species in ocular samples may also be crucial for adequate treatment of systemic infections.

Financial Disclosure:

NONE

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