title: Granulomatous uveitis and reactive arthritis as manifestations of post-streptococcal syndrome.
abstract: To report a case of bilateral granulomatous post-streptococcal syndrome uveitis in association with reactive arthritis as manifestation of post-streptococcal syndrome. To our knowledge, this could represent the first reported case in the literature. A 9-year-old girl, with no past ocular history, presented with a 5-day history of bilateral blurred vision, red eyes, photophobia and walking difficulties because of a right ankle pain. Ophthalmic examination disclosed a visual acuity limited to hand motion, mutton-fat keratic precipitates, anterior chamber cells and posterior synechiae in both eyes. Ocular pressure was normal. Physical examination showed a fever (38 °C), inflammatory ankle arthritis and scarlet fever (streptococcal lesion). Anti-streptococcal lysine O titer was 419 μ/ml. The patient was treated with topical steroids, cycloplegics, high-dose oral steroids and preventive course of penicillin with total improvement and no recurrence. Post-streptococcal syndrome should be considered in the etiology of acute bilateral granulomatous uveitis in children, and anti-streptococcal lysine O titer should be considered in serodiagnostic testing.
authors.affiliation: Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Boulevard 9 Avril, Bab Saadoun, 1006, Tunis, Tunisia.
authors.forename: Kais
authors.initials: K
authors.lastname: Abderrahim
authors.forename: Ahmed
authors.initials: A
authors.lastname: Chebil
authors.forename: Yosra
authors.initials: Y
authors.lastname: Falfoul
authors.forename: Mejda
authors.initials: M
authors.lastname: Bouladi
authors.forename: Leila
authors.initials: L
authors.lastname: El Matri
mesh_terms: D000842:Ankle; D016918:Arthritis, Reactive / Q000382:microbiology*; D002648:Child; D005260:Female; D006099:Granuloma / Q000382:microbiology*; D006801:Humans; D013290:Streptococcal Infections; D013577:Syndrome; D014606:Uveitis, Anterior / Q000382:microbiology*; D014786:Vision Disorders / Q000382:microbiology