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Letter to the Editor
Bilateral small retinal infiltrates during rickettsial infection
  1. JULIUS R LUKAS,
  2. STEFAN EGGER
  1. Department of Ophthalmology and Optometry, University Hospital Vienna, Austria
  2. Department of General Medicine I, Section of Infectious Diseases, University Hospital Vienna, Austria
  3. Department of Ophthalmology and Optometry, University Hospital Vienna, Austria
  1. BERNHARD PARSCHALK
  1. Department of Ophthalmology and Optometry, University Hospital Vienna, Austria
  2. Department of General Medicine I, Section of Infectious Diseases, University Hospital Vienna, Austria
  3. Department of Ophthalmology and Optometry, University Hospital Vienna, Austria
  1. MICHAEL STUR
  1. Department of Ophthalmology and Optometry, University Hospital Vienna, Austria
  2. Department of General Medicine I, Section of Infectious Diseases, University Hospital Vienna, Austria
  3. Department of Ophthalmology and Optometry, University Hospital Vienna, Austria
  1. J R Lukas, Department of Ophthalmology and Optometry, University of Vienna, A-1090 Vienna, Waehringer Guertel 18-20, Austria.

https://doi.org/10.1136/bjo.82.10.1215c

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    Editor,—Rickettsiae may cause heterogeneous retinal manifestations, the most characteristic of which are vascular lesions, periphlebitis, retinal haemorrhages and oedema, central retinal thrombosis, and papilloedema.1-5 We present the first case in which rickettsiae led to small retinal white infiltrates.

    CASE REPORT

    A previously healthy 25 year old woman had a fever up to 40°C of unknown origin during a trip to Queensland, Australia in August. Five days after the onset of fever a generalised maculopapular rash and a black lesion on the forefoot (eschar) were visible, without a known history of a tick bite. The patient was transferred to our hospital with the signs of general illness. Extensive examination for infectious disease including eye examination was initiated.

    Visual acuity was 20/25 in both eyes. Slit lamp examination revealed bilateral conjunctival hyperaemia. Moderate inflammation of the vitreous in both eyes was visible. Fundus examination disclosed bilateral small white infiltrates within the neurosensory retina, practically without …

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