title: Rabbit hunter uveitis: case report of tularemia uveitis.
abstract: BACKGROUND
  Literature reports on ophthalmological manifestations related to tularemia, a zoonose caused by the bacterium Francisella tularensis, largely refer to Parinaud's oculoglandular syndrome, which consists of the association of conjunctivitis with preauricular lymphadenitis. In this paper, we report a case of intraocular inflammation during tularemia infection.
  
  
  METHODS
  A 52-year-old Caucasian man was diagnosed with unilateral uveitis. The uveitis was posterior, with a 2+ vitritis and a large yellowish lesion involving the macula with an overlying sub-retinal detachment, extending inferiorly, and subretinal hemorrhages. Fluorescein angiography showed a late hyperfluorescence with focal vascular leakage. Ultrasound biomicroscopy confirmed the presence of a 3.8 mm parietal granuloma with a few calcifications in the left eye. While extensive work-up eliminated any other infectious and non-infectious etiology, tularemia was diagnosed by advanced serology consisting of two-dimensional Western-immunoblotting. The patient, a hunter, recalled having killed rabbits in the days before the symptoms appeared. Uveitis was rapidly controlled following treatment with doxycycline, yet three years after initiation of the treatment, the patient still complained of loss of vision in the left eye with a central scotoma.
  
  
  CONCLUSIONS
  Posterior uveitis may be an infrequent manifestation of tularemia infection, and therefore this infection should be considered in the differential diagnosis of intraocular inflammation in areas where F. tularensis is endemic.
authors: Ophtalmology Department, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors: Céline
authors: C
authors: Terrada
authors: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE) UMR CNRS 6236 IRD 198, Méditerranée Infection, Aix-Marseille-Université, 27 Boulevard Jean Moulin, 13385, Marseille Cedex 5, France.
authors: Said
authors: S
authors: Azza
authors: Ophtalmology Department, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors: Bahram
authors: B
authors: Bodaghi
authors: Ophtalmology Department, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors: Phuc
authors: P
authors: Le Hoang
authors: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE) UMR CNRS 6236 IRD 198, Méditerranée Infection, Aix-Marseille-Université, 27 Boulevard Jean Moulin, 13385, Marseille Cedex 5, France. michel.drancourt@univ-amu.fr.
authors: Michel
authors: M
authors: Drancourt
mesh_terms: D000818:Animals; D003937:Diagnosis, Differential; D005604:Francisella tularensis / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011817:Rabbits / Q000382:microbiology; D014406:Tularemia / Q000150:complications*; D014605:Uveitis / Q000382:microbiology*
keywords: Francisella tularensis; Parinaud’s syndrome; Tularemia; Uveitis