TITLE:
Mediterranean Spotted Fever Complicated with Thrombosis of the Left Central Retinal Vein: A Case Report and Literature Review
AUTHORS:
Ermira Muco, Arta Kushi, Neada Hoxha, Anila Monka, Ali Tonuzi, Majlinda Kota, Artan Bego, Dhimiter Kraja
KEYWORDS:
Mediterranean Spotted Fever, Rickettsia conorii, Thrombosis, Central Retinal Vein
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.6 No.4,
April
24,
2018
ABSTRACT: We
describe a case of Mediterranean spotted fever complicated with thrombosis of
the left central retinal vein. A 41-year-old woman patient living in the city
Scodra was referred to our hospital in October 2017 for high fever 40°C, muscular and articular pains, severe headache, maculopapular rash, chills, photophobia and visual loss in his left eye. Ocular examination
showed vision acuity: OD 8/10, OS 2/10. Funduscopic examination complemented
with fluorescein angiography showed: optic nerve papilla with clear contours,
diffuse hemorrhages in the contest off retinal vein thrombosis, white retinal
lesions, vascular sheathing and macular cystoids edema. R. conorii antibodies
were identified by ELISA anti Rickettsia
conorii IgM,
IgG and Weil-Felix Ox-19 test. Investigation of other infective agents and the
immunological panel were negative. After treatment with doxycycline 200 mg/day for 10 days vision acuity was OD: 8/10 OS:
6/10; FO: There are less hemorrhages in fluorescein angiograph and OCT showed a
reduced macular cystoids edema. Mediterranean spotted fever should be
considered in the differential diagnosis of a patient who presents with an
acute febrile disease accompanied by maculopapular rash especially in the seasons
of spring, summer or autumn.