Ocular manifestations associated with murine typhus.
OBJECTIVE
To characterise and analyse ocular manifestations associated with acute murine typhus (MT), an infectious disease caused by Rickettsia typhi.


METHODS
Nine consecutive patients (18 eyes) with serologically confirmed MT at the acute stage were enrolled in this prospective, non-comparative study. All patients underwent complete ophthalmic examination, including dilated biomicroscopic fundus examination, fundus photography, fluorescein angiography (FA) and indocyanine green (ICG) angiography.


RESULTS
Of nine patients, eight (88.9%) had bilateral ocular involvement related to MT, with (n = 3) or without (n = 5) associated ocular symptoms. Findings included mild vitreous inflammation (10 eyes; 55.6%), white retinal lesions (nine eyes; 50%), retinal haemorrhages (four eyes; 22.2%), retinal vascular leakage (seven eyes; 38.9%), hypofluorescent choroidal dots on FA and/or ICG angiography (11 eyes; 61.1%), optic-disc swelling (two eyes; 11.1%), optic neuritis (one eye; 5.6%) and optic-disc staining (11 eyes; 61.1%). All ocular findings had a self-limited course.


CONCLUSIONS
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.
Department of Ophthalmology, Fattouma Bourguiba University Hospital, 5019, Monastir, Tunisia. moncef.khairallah@rns.tn
M
M
Khairallah
S
S
Ben Yahia
A
A
Toumi
B
B
Jelliti
C
C
Loussaief
F B
FB
Romdhane
R
R
Messaoud
M
M
Chakroun
D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004318:Doxycycline / Q000627:therapeutic use; D015818:Eye Infections, Bacterial / Q000150:complications* / Q000188:drug therapy; D005260:Female; D005451:Fluorescein Angiography; D024841:Fluoroquinolones / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014437:Typhus, Endemic Flea-Borne / Q000150:complications* / Q000188:drug therapy; D014792:Visual Acuity; D055815:Young Adult
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D004318:Doxycycline