Abderrahim Kais, Chebil Ahmed, Falfoul Yosra, Bouladi Mejda, El Matri Leila
Department B of Ophthalmology, Hedi Rais Institute of Ophthalmology, Boulevard 9 Avril, Bab Saadoun, 1006, Tunis, Tunisia.
Int Ophthalmol. 2015 Oct;35(5):641-3. doi: 10.1007/s10792-012-9626-1. Epub 2012 Sep 18.
To report a case of bilateral granulomatous post-streptococcal syndrome uveitis in association with reactive arthritis as manifestation of post-streptococcal syndrome. To our knowledge, this could represent the first reported case in the literature. A 9-year-old girl, with no past ocular history, presented with a 5-day history of bilateral blurred vision, red eyes, photophobia and walking difficulties because of a right ankle pain. Ophthalmic examination disclosed a visual acuity limited to hand motion, mutton-fat keratic precipitates, anterior chamber cells and posterior synechiae in both eyes. Ocular pressure was normal. Physical examination showed a fever (38 °C), inflammatory ankle arthritis and scarlet fever (streptococcal lesion). Anti-streptococcal lysine O titer was 419 μ/ml. The patient was treated with topical steroids, cycloplegics, high-dose oral steroids and preventive course of penicillin with total improvement and no recurrence. Post-streptococcal syndrome should be considered in the etiology of acute bilateral granulomatous uveitis in children, and anti-streptococcal lysine O titer should be considered in serodiagnostic testing.
报告一例双侧肉芽肿性链球菌感染后综合征葡萄膜炎伴反应性关节炎，作为链球菌感染后综合征的表现。据我们所知，这可能是文献中首次报道的病例。一名9岁女孩，既往无眼部病史，因双眼视力模糊、眼红、畏光及右踝关节疼痛导致行走困难5天前来就诊。眼科检查发现双眼视力仅能看到手动，有羊脂状角膜后沉着物、前房细胞及虹膜后粘连。眼压正常。体格检查显示发热（38℃）、踝关节炎性关节炎及猩红热（链球菌感染病灶）。抗链球菌溶血素O滴度为419μ/ml。患者接受局部类固醇、睫状肌麻痹剂、大剂量口服类固醇及青霉素预防性治疗，病情完全改善且无复发。儿童急性双侧肉芽肿性葡萄膜炎的病因应考虑链球菌感染后综合征，血清学诊断检测应考虑抗链球菌溶血素O滴度。
