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Acute posterior multifocal placoid pigment epitheliopathy after acute group A streptococcal infection
C Y Lowder1, R E Foster, S M Gordon
1Division of Ophthalmology, Cleveland Clinic Foundation, USA.
Purpose:
We studied a case of acute posterior multifocal placoid pigment epitheliopathy in a 40-year-old man who had had an acute febrile illness.
Methods:
The medical record was reviewed for clinical manifestations, course of disease, and laboratory findings, including results of fluorescein and indocyanine green angiography.
Results:
The patient had the typical clinical course of acute posterior multifocal placoid pigment epitheliopathy with spontaneous resolution of posterior pole lesions and improvement in visual acuity from 20/60 to 20/20. The laboratory evaluation was remarkable for a rise in the anti-DNAse B antibody titer between initial and convalescent-phase serum samples, providing evidence of recent group A streptococcal infection.
Conclusion:
Although acute posterior multifocal placoid pigment epitheliopathy is often attributed to a postviral condition, this syndrome may also develop after an acute group A streptococcal infection.
Insights
Acute posterior multifocal placoid pigment epitheliopathy can follow group A streptococcal infections, not just viral illnesses. This finding expands understanding of the condition
Area of Science:
- Ophthalmology
- Infectious Disease
Background:
- Acute posterior multifocal placoid pigment epitheliopathy (APMPPE) is an inflammatory eye condition.
- It is often associated with preceding viral infections.
Observation:
- A case study of a 40-year-old man with APMPPE following an acute febrile illness.
- Clinical manifestations, disease course, and laboratory findings were reviewed.
Findings:
- The patient experienced typical APMPPE with spontaneous resolution and improved visual acuity.
- Elevated anti-DNAse B antibody titers indicated a recent group A streptococcal infection.
Implications:
- This case suggests APMPPE may be triggered by bacterial infections, specifically group A streptococcus.
- Broadens the differential diagnosis for APMPPE etiology beyond postviral syndromes.