J Korean Ophthalmol Soc.  2010 Oct;51(10):1414-1418.

Case of Tsutsugamushi Disease With Anterior Uveitis

• Choi ES
• Moon SJ
• Kim HS
• Lee KH

Abstract

PURPOSE
To report a single case of tsutsugamushi disease with anterior uveitis and eschars on the upper eyelid.
CASE SUMMARY
A 56-year-old female patient complained of ocular pain and gradually decreasing visual acuity in her right eye. On physical examination, lymphadenopathy was palpable on the right side of the neck, and eschars were observed on the forehead and upper eyelid. On slit lamp examination, conjunctival injection, episcleral vessel dilations and severe intraocular inflammatory reaction were observed. Fundus examination showed no abnormal findings. A blood test was submitted for analysis, and tsutsugamushi disease was diagnosed. The patient's ocular manifestations responded well to treatment with steroids. After three weeks, the patient showed improvement on ocular examination, and no problems were observed at the six-month follow-up.
CONCLUSIONS
Although ocular manifestation of tsutusgamushi disease with conjunctivitis and limbitis has previously been reported, ocular manifestation of tsutusgamushi disease with anterior uveitis has not been reported. Anterior uveitis may respond satisfactorily to steroid treatment, along with improvement in systemic conditions.

Keyword

Anterior uveitis; Eschars; Tsutsugamushi disease

MeSH Terms

Conjunctivitis
Eye
Eyelids
Female
Follow-Up Studies
Forehead
Glycosaminoglycans
Hematologic Tests
Humans
Lymphatic Diseases
Middle Aged
Neck
Physical Examination
Scrub Typhus
Steroids
Uveitis, Anterior
Visual Acuity
Glycosaminoglycans
Steroids

Figure

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  Figure 1. Photographs of a 56-year-old woman with pain sensation in her right eye. (A) The photograph shows eschars on the right upper lid and forehead. (B) Dilated episcleral vessels and conjuctival injection. (C), (D) Anterior chamber inflammation and keratic precipitates located in the inner endothelial layer of the cornea.

• 

  Figure 2. Three weeks after treatment. (A) Eschar on the right upper lid disappeared. (B) Eschar remained ulcer on her frontal head. (C) Dilated conjunctival and episcleral vessels were restored. (D) Anterior chamber inflammation and keratic precipitates resolved.

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