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Papilledema in endemic typhus

E Manor, F Politi, A Marmor

    American Journal of Ophthalmology
    |October 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    Severe papilledema in a young woman was linked to murine typhus. The vision condition resolved as the rickettsial infection cleared, showing a direct correlation.

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    Area of Science:

    • Ophthalmology
    • Infectious Diseases
    • Neurology

    Background:

    • Papilledema, or swollen optic discs, can be a sign of serious underlying conditions.
    • Rickettsial infections, like murine typhus, can present with diverse neurological and ocular manifestations.

    Observation:

    • A 21-year-old female presented with acute febrile illness and severe bilateral papilledema.
    • Ophthalmic findings included blurred optic disk margins, disk elevation up to 5 diopters, splinter hemorrhages, cotton-wool exudates, cytoid bodies, and retinal vein sheathing.
    • Cerebrospinal fluid, neurological exams, and neuroimaging were normal, ruling out intracranial hypertension.

    Findings:

    • The febrile illness was diagnosed as murine typhus through serologic testing, with high Proteus OX-19 agglutination titers (1:12800) and positive complement fixation tests for Rickettsia mooseri (1:640).

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  • The papilledema resolved completely as the patient recovered from the rickettsial infection, indicating a direct causal link.

    • Implications:

    • This case highlights a rare ocular manifestation of murine typhus.
    • It underscores the importance of considering infectious etiologies in patients presenting with papilledema, even with normal neurological findings.
    • Prompt diagnosis and treatment of rickettsial infections are crucial for preventing potentially severe complications, including vision loss.