Retinal manifestations of acute murine typhus.
OBJECTIVE
To report the ocular manifestations of acute serologically confirmed murine typhus.


METHODS
A retrospective analysis of the clinical history, photography and fluorescein angiography of two patients with acute murine typhus with ocular involvement was conducted.


RESULTS
A 38 year old male and a 49 year old female were included in the study. Both complained of fever, headache, rash, night sweats and pulmonary symptoms. They had noted the recent onset of diminished visual acuity and floaters. Examination of the posterior pole revealed mild optic nerve head edema (in one patient), intraretinal hemorrhages and small localized areas of retinal whitening. The history confirmed that both patients had been exposed to fleas and the serologic testing was positive for Rickettsia typhi. The systemic and ocular findings resolved after the use of systemic antibiotics.


CONCLUSIONS
Rickettsial diseases such as murine typhus should be included in the differential diagnosis of otherwise healthy individuals who present with an acute systemic febrile illness and retinitis or neuroretinitis.


CONCLUSIONS
The clinical features of two patients with serologically proven acute murine typhus with ocular involvement are presented. Both patients presented with a retinal whitening that resolved after treatment.
Hudson
H L
HL
Department of Ophthalmology, University of Southern California School of Medicine, Los Angeles, CA, USA.
Thach
A B
AB
Lopez
P F
PF
D000208:Acute Disease; D000328:Adult; D000907:Antibodies, Bacterial / Q000032:analysis; D003937:Diagnosis, Differential; D004318:Doxycycline / Q000627:therapeutic use; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D008297:Male; D008875:Middle Aged; D009643:Norfloxacin / Q000627:therapeutic use; D012160:Retina / Q000382:microbiology / Q000473:pathology; D012173:Retinitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D012189:Retrospective Studies; D012286:Rickettsia typhi / Q000276:immunology; D014437:Typhus, Endemic Flea-Borne / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
D000907:Antibodies, Bacterial; D009643:Norfloxacin; D004318:Doxycycline