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Recurrent episcleritis associated with brucellosis
K Güngör1, N A Bekir, M Namiduru
1Department of Ophthalmology, Medical Faculty, Gaziantep University, Kolejtepe, Turkey. gulenkg@superonline.com
Purpose:
To document the clinical course and the treatment of episcleritis associated with brucellosis.
Methods:
Three consecutive cases of patients with recurrent episcleritis associated with brucellosis were evaluated through clinical and laboratory data including serology (tube agglutination), blood culture, and synovial fluid culture.
Results:
All the patients had ingested contaminated milk and/or fresh cheese. The diagnosis of brucellosis was confirmed by high antibody titer, positive blood culture, negative synovial fluid culture and unresponsive condition to the previous nonspecific therapy for episcleritis and reactive arthritis. The patients responded well to the therapy with doxycycline and rifampicin.
Conclusion:
We proposed that recurrent episcleritis had a co-occurence with reactive arthritis in the course of the brucellosis, and that it responded well to the antibrucellar antibiotics rather than to steroids. This also implies that brucellosis as a rule is an underlying triggering infection associated with reactive arthritis.
Insights
Brucellosis can cause recurrent episcleritis, an eye inflammation often linked with reactive arthritis. Effective treatment involves specific antibiotics like doxycycline and rifampicin, not steroids.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Rheumatology
Background:
- Brucellosis is a zoonotic infection with diverse clinical manifestations.
- Episcleritis can be a rare ocular complication of systemic infections.
- The association between brucellosis, episcleritis, and reactive arthritis requires further elucidation.
Purpose of the Study:
- To describe the clinical presentation and management of episcleritis in brucellosis patients.
- To investigate the co-occurrence of episcleritis and reactive arthritis in brucellosis.
Main Methods:
- Retrospective analysis of three consecutive cases of recurrent episcleritis.
- Clinical evaluation and laboratory investigations including serology (tube agglutination), blood culture, and synovial fluid culture.
- Assessment of treatment response to antibiotics and steroids.
Main Results:
- All patients reported consumption of contaminated milk or fresh cheese.
- Brucellosis diagnosis confirmed by high antibody titers and positive blood cultures.
- Patients showed good response to doxycycline and rifampicin therapy for episcleritis and reactive arthritis.
Conclusions:
- Recurrent episcleritis frequently co-occurs with reactive arthritis in brucellosis.
- Antibrucellar antibiotics are effective, while steroids are less so, in managing this condition.
- Brucellosis should be considered a potential underlying trigger for reactive arthritis.