title: Acute multifocal placoid pigment epitheliopathy associated with erythema nodosum and a flu-like illness.
abstract: Acute multifocal placoid pigment epitheliopathy (AMPPE) is a rare inflammatory vasculitis of the choroid. Despite primarily being a disorder of the eye, a number of extra-ophthalmological features have been described in AMPPE and may accompany the visual disturbances. Such patients may be admitted under the care of physicians for evaluation of a systemic illness. We report AMPPE occurring in a 37-year-old man in his thirties admitted with a flu-like illness, erythema nodosum, visual disturbances and raised inflammatory markers. Conditions such as bacterial endocarditis and vasculitis, were considered before a diagnosis of AMPPE was made. The case illustrates how AMPPE can be a diagnostic dilemma, particularly when associated with extra-ophthalmological features. The epidemiology, clinical features, diagnosis and therapy of AMPPE are also discussed.
authors.affiliation: Department of Microbiology and Infectious Diseases, The Canberra Hospital, Woden, ACT, Australia. sanjaya.senanayake@act.gov.au
authors.forename: S N
authors.initials: SN
authors.lastname: Senanayake
authors.forename: S
authors.initials: S
authors.lastname: Selvadurai
authors.forename: C A
authors.initials: CA
authors.lastname: Hawkins
authors.forename: D
authors.initials: D
authors.lastname: Tridgell
mesh_terms: D000328:Adult; D002825:Chorioretinitis / Q000175:diagnosis* / Q000473:pathology; D004893:Erythema Nodosum / Q000175:diagnosis* / Q000473:pathology*; D005451:Fluorescein Angiography / Q000379:methods; D006801:Humans; D007249:Inflammation; D007251:Influenza, Human / Q000175:diagnosis; D008297:Male; D010857:Pigment Epithelium of Eye / Q000002:abnormalities*; D012164:Retinal Diseases / Q000150:complications / Q000175:diagnosis; D014786:Vision Disorders / Q000150:complications / Q000175:diagnosis