Ocular manifestations associated with murine typhus

Abstract

Ocular involvement is frequently observed in acute MT. A systematic fundus examination, complemented by angiography in selected cases, may be helpful in establishing an early clinical diagnosis of the disease while serological testing is pending.

New Infectious Etiologies for Posterior Uveitis

“…Ocular involvement is common in patients with rickettsioses, but since it is frequently asymptomatic and self-limited, it may be easily overlooked [1,2,3,31,32,33]. Inner retinitis with or without associated mild or moderate vitritis is the most common clinical finding [1,2,3,31,32,33]. It presents in the form of white retinal lesions typically adjacent to retinal vessels (fig.…”

“…A subclinical choroidal involvement in the form of multiple dark dots on FA was observed in more than 15% of patients with Mediterranean spotted fever [31]. Indocyanine green angiography shows small hypofluorescent spots in the intermediate and late phases, areas of hyperfluorescence, choroidal vascular filling defect, and choroidal vascular staining [32]. Other chorioretinal changes include cystoid macular edema and endophthalmitis [1,2,3,31,32,33,34].…”

“…FA shows early hypofluorescence and late staining of large retinal lesions (fig. 6b) and slight hypofluorescence or isofluorescence of small retinal lesions [31,32]. SRD, accurately detected by OCT, frequently accompanies large foci of rickettsial retinitis.…”

“…A rickettsial disease should be suspected, during spring or summer, in the presence of the triad of high fever, headache and general malaise, and skin rash in a patient living in or traveling back from a region endemic for rickettsioses [1,2,3]. Ocular involvement is common in patients with rickettsioses, but since it is frequently asymptomatic and self-limited, it may be easily overlooked [1,2,3,31,32,33]. Inner retinitis with or without associated mild or moderate vitritis is the most common clinical finding [1,2,3,31,32,33].…”

“…SRD, accurately detected by OCT, frequently accompanies large foci of rickettsial retinitis. Retinal vascular lesions in patients with rickettsial disease may include focal or diffuse vascular sheathing, vascular leakage, retinal hemorrhages, and retinal vascular occlusions, including branch retinal artery occlusion and branch retinal vein occlusion or subocclusion, leading to retinal neovascularization and vitreous hemorrhage [1,2,3,31,32,33,34]. A subclinical choroidal involvement in the form of multiple dark dots on FA was observed in more than 15% of patients with Mediterranean spotted fever [31].…”