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April 2006

Ocular Brucellosis vs Vogt-Koyanagi-Harada Syndrome—Reply

Arch Ophthalmol. 2006;124(4):609. doi:10.1001/archopht.124.4.609-a

In reply

We thank Drs Goldstein and Tessler for their careful reading of our article and for their valuable comments. Up to 20% of patients with brucellosis are afebrile during the acute phase of the disease.1 Occurrence of positive blood cultures can range from 50% to 90%,2 and with some Brucella species, it can be even lower.3 In some of the “proven” reported cases4,5 of uveitis due to Brucella, there is no mention of the results of blood cultures. For these reasons, a negative blood culture does not exclude the diagnosis of Brucella infection. A presumptive diagnosis can be made based on the serologic tests. In reported cases4 exclusively with choroiditis, like our case, the diagnosis was made by agglutination serologic testing. Drs Goldstein and Tessler did not mention that the diagnosis is achieved by agglutination from the vitreous fluid only in cases with endophthalmitis or severe posterior uveitis.

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