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Rickettsial retinitis-an Indian perspective.

Ankush Kawali1, Padmamalini Mahendradas2, Priya Srinivasan3

  • 1Uveitis and Ocular Immunology Services, Narayana Nethralaya, 121/C, Chord Road, 1st 'R' Block, Rajajinagar, Bangalore, 560010, India. akawali332@gmail.com.

Journal of Ophthalmic Inflammation and Infection
|November 28, 2015
PubMed
Summary
This summary is machine-generated.

Rickettsial retinitis (RR) is rare in India. This case series suggests RR can present with fever and rash, with Indian tick typhus and epidemic typhus as common causes, and offers a good visual prognosis.

Keywords:
IndiaRetinitisRickettsiaTyphusUveitis

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Medical Microbiology

Background:

  • Rickettsiosis is prevalent in India, yet reports of rickettsial retinitis (RR) are scarce.
  • The specific rickettsial subtypes associated with retinitis in India remain understudied.

Purpose of the Study:

  • To report a case series of presumed rickettsial retinitis (RR).
  • To describe the disease course, visual outcomes, and associated rickettsial subtypes in patients with RR.

Main Methods:

  • Retrospective analysis of 10 patients (19 eyes) diagnosed with presumed RR between March 2006 and October 2014.
  • Diagnosis based on fever, retinitis, positive Weil-Felix test, and negative chikungunya/dengue serology.
  • Rickettsial subtypes identified using the Weil-Felix test.

Main Results:

  • Nine patients had bilateral retinitis; one reported a dog tick bite, and four had skin rashes.
  • Epidemic typhus and Indian tick typhus were identified as common rickettsial subtypes.
  • Patients presented 2-4 weeks after fever onset.

Conclusions:

  • Retinitis with fever, rash, and a positive Weil-Felix test suggests rickettsial etiology.
  • Ocular manifestations may represent an immune response to systemic rickettsial infection.
  • Indian tick typhus and epidemic typhus are potential common subtypes; RR has a good visual prognosis despite aggressive presentation.