Aims: To characterize and analyze ocular manifestations associated with acute murine typhus (MT), an infectious disease caused by Rickettsia typhi.
Methods: Nine consecutive patients (18 eyes) with serologically confirmed MT at the acute stage were enrolled in this prospective, noncomparative study. All patients underwent complete ophthalmic examination, including dilated biomicroscopic fundus examination, fundus photography, fluorescein angiography (FA), and indocyanine green (ICG) angiography.
Results: Of 9 patients, 8 (88.9%) had bilateral ocular involvement related to MT, with (n=3) or without (n=5) associated ocular symptoms. Findings included mild vitreous inflammation (10 eyes; 55.6%), white retinal lesions (9 eyes; 50%), retinal hemorrhages (4 eyes; 22.2%), retinal vascular leakage (7 eyes; 38.9%), hypofluorescent choroidal dots on FA and/or ICG angiography (11 eyes; 61.1%), optic disc swelling (2 eyes; 11.1%), optic neuritis (1 eye; 5.6%), and optic disc staining (11 eyes; 61.1%). All ocular findings had a self-limited course.
Conclusion: Ocular involvement is frequently observed in acute MT. A systematic fundus examination, complemented by angiography in selected cases, may be helpful in establishing an early clinical diagnosis of the disease while serologic testing is pending.