Rabbit hunter uveitis: case report of tularemia uveitis

BMC Ophthalmology

Case Report

Céline Terrada¹  Phuc Le Hoang¹  Bahram Bodaghi¹  Said Azza²  Michel Drancourt² 

[1] Ophtalmology Department, Assistance Publique-Hôpitaux de Paris, Paris, France;Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE) UMR CNRS 6236 IRD 198, Méditerranée Infection, Aix-Marseille-Université, 27 Boulevard Jean Moulin, 13385, Marseille Cedex 5, France;

关键词: Tularemia;    Uveitis;    Francisella tularensis;    Parinaud’s syndrome;   

DOI  :  10.1186/s12886-016-0332-z

 received in 2016-01-12, accepted in 2016-08-23,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundLiterature reports on ophthalmological manifestations related to tularemia, a zoonose caused by the bacterium Francisella tularensis, largely refer to Parinaud’s oculoglandular syndrome, which consists of the association of conjunctivitis with preauricular lymphadenitis. In this paper, we report a case of intraocular inflammation during tularemia infection.Case presentationA 52-year-old Caucasian man was diagnosed with unilateral uveitis. The uveitis was posterior, with a 2+ vitritis and a large yellowish lesion involving the macula with an overlying sub-retinal detachment, extending inferiorly, and subretinal hemorrhages. Fluorescein angiography showed a late hyperfluorescence with focal vascular leakage. Ultrasound biomicroscopy confirmed the presence of a 3.8 mm parietal granuloma with a few calcifications in the left eye. While extensive work-up eliminated any other infectious and non-infectious etiology, tularemia was diagnosed by advanced serology consisting of two-dimensional Western-immunoblotting. The patient, a hunter, recalled having killed rabbits in the days before the symptoms appeared. Uveitis was rapidly controlled following treatment with doxycycline, yet three years after initiation of the treatment, the patient still complained of loss of vision in the left eye with a central scotoma.ConclusionsPosterior uveitis may be an infrequent manifestation of tularemia infection, and therefore this infection should be considered in the differential diagnosis of intraocular inflammation in areas where F. tularensis is endemic.

【 授权许可】

CC BY   
© The Author(s). 2016