15Aug 2017

RARE OPHTHALMIC MANIFESTATIONS OF RICKETTSIAL INFECTIONS.

  • Dept. of General Medicine, St. John?s Medical College, Bangalore-56034.
  • Dept. of Ophthalmology, St. John?s Medical College, Bangalore-560034.
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Background: Rickettsial infections are re-emerging health problems in the country. There is a paucity of data on the ophthalmic manifestations of rickettsial disease in India. Majority of the ocular manifestations reported involve the posterior segment with very few documented cases of anterior segment manifestations. We report cases of febrile illness associated with acute anterior uveitis which were diagnosed as rickettsial infection. Findings: Four patients presented with febrile illness with acute anterior uveitis. Three out of the four patients developed eye signs between day eleven to day thirteen of onset of fever. Three patients had only unilateral uveitis with the fourth case having bilateral. Patients were treated with doxycycline along with steroid and cycloplegic eye drops and improved symptomatically. No recurrence of anterior uveitis was noted on follow up. Conclusion: The possibility of rickettsial fever must be considered in the differential diagnosis of acute febrile illness with acute anterior uveitis as early initiation of treatment can lead to better outcomes.

  1. Parola P, Raoult D (1998) Rickettsioses eruptives. EMC (Elsevier Paris) Maladies infectieuses, 8-037-I-20, 24 p.
  2. Mc Dade JE (1998) Rickettsial diseases. In: Hausler WJ, Sussman M, eds. Topley and Wilson?s Microbilogy and Microbial Infections, 9th ed. London: Arnold 3:995-1011.
  3. Alio, J., Ruiz-Beltran, R., Herrero-Herrero, J. I., Hernandez, E., Guinaldo, V., & Millan, A. (1987). Retinal manifestations of Mediterranean spotted fever. Ophthalmologica, 195(1), 31-37.
  4. Khairallah, M., Ladjimi, A., Chakroun, M., Messaoud, R., Yahia, S. B., Zaouali, Romdhane, F.B & Bouzouaia, N. (2004). Posterior segment manifestations of Rickettsia conorii infection. Ophthalmology, 111(3), 529-534.
  5. Agahan, A. L., Torres, J., Fuentes-P?ez, G., Mart?nez-Osorio, H., Ordu?a, A., & Calonge, M. (2011). Intraocular inflammation as the main manifestation of Rickettsia conorii infection. Clinical ophthalmology (Auckland, NZ), 5, 1401.
  6. Abroug, N., Khochtali, S., Kahloun, R., Mahmoud, A., Attia, S., & Khairallah, M. (2014). Ocular Manifestations of Rickettsial Disease. Journal of Infectious Diseases and Therapy.
  7. Cherubini, T. D., & Spaeth, G. L. (1969). Anterior Nongranulomatous Uveitis Associated With Rocky Mountain Spotted Fever: First Report of a Case. Archives of Ophthalmology, 81(3), 363-365.
  8. Beltran, L. M., Garc?a, S., Vallejo, A. J., & Bernabeu-Wittel, M. (2011). Bilateral anterior uveitis and Rickettsia typhi infection. Enfermedades infecciosas y microbiologia clinica, 29(3), 235.
  9. Mittal, V., Gupta, N., Bhattacharya, D., Kumar, K., Ichhpujani, R. L., Singh, S., Chhabra, M.& Rana, U. V. S. (2012). Serological evidence of rickettsial infections in Delhi. The Indian journal of medical research, 135(4), 538.
  10. Dasari, V., Kaur, P., & Murhekar, M. V. (2014). Rickettsial disease outbreaks in India: A review. Annals of Tropical Medicine and Public Health, 7(6), 249.
  11. Ajantha, G. S., Patil, S. S., Chitharagi, V. B., & Kulkarni, R. D. (2013). Rickettsiosis: a cause of acute febrile illness and value of Weil-Felix test. Indian journal of public health, 57(3), 182.
  12. Mahajan, S. K., Kashyap, R., Kanga, A., Sharma, V., Prasher, B. S., & Pal, L. S. (2006). Relevance of Weil-Felix test in diagnosis of scrub typhus in India. JAPI, 54, 619.
  13. Kawali, A., Mahendradas, P., Srinivasan, P., Yadav, N. K., Avadhani, K., Gupta, K., & Shetty, R. (2015). Rickettsial retinitis?an Indian perspective. Journal of ophthalmic inflammation and infection, 5(1), 37.
  14. Pradeep, T. G., Satyanarayanan, S., & Krishnaswamy, M. (2015). Bilateral Uveitis in Rickettsial Disease. Journal of Infectious Diseases and Therapy, 1-2.
  15. Bazin, R. (2002). Rickettsial diseases. Diagnosis and treatment of uveitis. Philadelphia, PA: WB Saunders Co, 297-304.
  16. Pinna, A., Sotgiu, M., Carta, F., Zanetti, S., & Fadda, G. (1997). Oculoglandular syndrome in Mediterranean spotted fever acquired through the eye. British journal of ophthalmology, 81(2), 168-168.
  17. Khairallah, M., Jelliti, B., & Jenzeri, S. (2009). Emergent infectious uveitis. Middle East African journal of ophthalmology, 16(4), 225.

[Seena Sankar, Shruthi Kulkarni, Manjoo CS and Nitin Yashas Murthy. (2017); RARE OPHTHALMIC MANIFESTATIONS OF RICKETTSIAL INFECTIONS. Int. J. of Adv. Res. 5 (Aug). 1027-1031] (ISSN 2320-5407). www.journalijar.com

Nitin Yashas Murthy
Senior Resident, Dept. of General Medicine, St.John's Medical College, bangalore-560034

DOI:

Article DOI: 10.21474/IJAR01/5152      
DOI URL: http://dx.doi.org/10.21474/IJAR01/5152

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