Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.
Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry-605006, India, Email:
J R Coll Physicians Edinb. 2021 Sep;51(3):258-261. doi: 10.4997/JRCPE.2021.310.
A 20-year-old male presented with acute lower limb oligoarthritis and enthesitis followed by acute onset redness, watering, pain and decreased vision in the right eye. He had recent history of diarrhoea with fever. Erythrocyte sedimentation rate and high-sensitivity C-reactive protein (hsCRP) were raised and human leukocyte antigen-B27 was positive. The best corrected visual acuity (BCVA) in the right eye was 20/120 and it showed a paracentral shallow corneal ulcer of size 3 × 4 mm with underlying dense stromal infiltrates and haze. Microbiological evaluation of corneal scrapings was reported as Staphylococcus hominis. The epithelium healed on topical antibiotics in one week, but there were persistent punctate erosions and pleomorphic anterior stromal infiltrates and haze. The residual keratitis healed completely on topical steroids in ten days, with BCVA improving to 20/20. A diagnosis of reactive arthritis with immune-mediated keratitis was made.
一位 20 岁男性出现急性下肢寡关节炎和肌腱附着点炎，随后右眼出现急性发红、流泪、疼痛和视力下降。他有近期腹泻伴发热病史。红细胞沉降率和高敏 C 反应蛋白（hsCRP）升高，人类白细胞抗原-B27 阳性。右眼最佳矫正视力（BCVA）为 20/120，显示 3×4mm 大小的旁中心浅层角膜溃疡，伴有基底密集的基质浸润和混浊。角膜刮片的微生物评估报告为人葡萄球菌。上皮在一周内通过局部抗生素愈合，但仍存在持续性点状糜烂和多形性前基质浸润和混浊。残余角膜炎在十天内通过局部类固醇完全愈合，BCVA 提高至 20/20。诊断为反应性关节炎伴免疫介导性角膜炎。
