Rickettsial keratitis in a case of Mediterranean spotted fever

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Rickettsia conorii is a bacterium primarily known for causing Mediterranean spotted fever.
• Infectious keratitis, or corneal inflammation, can result from various microbial agents.
• Ameboid-like corneal ulcers are typically associated with Acanthamoeba infections.

Observation:

• A novel case of infectious keratitis presenting as an ameboid-like corneal ulcer was documented.
• The corneal ulcer was attributed to Rickettsia conorii infection.
• Systemic dissemination of Rickettsia conorii likely led to ocular surface contamination via tears.

Findings:

• This represents the first reported instance of Rickettsia conorii causing infectious keratitis.
• Treatment with topical tetracycline ointment proved effective in resolving the corneal ulcer.
• The clinical presentation mimicked other forms of ameboid-like keratitis.

Implications:

• Rickettsial keratitis should be included in the differential diagnosis for ameboid-like corneal ulcers.
• This finding is particularly relevant in regions endemic for Mediterranean spotted fever.
• Early diagnosis and appropriate antibiotic therapy are crucial for managing this rare ocular condition.