Moore Spencer M, McAllister Mark A, Thomas Tanu O
Department of Ophthalmology & Vision Science, College of Medicine, University of Arizona, 655 N Alvernon Way, Tucson, AZ, 85711, USA.
Department of Ophthalmology, Southern Arizona Veterans Administration Healthcare System, 3601 S 6th Ave, Tucson, AZ, 85723, USA.
Am J Ophthalmol Case Rep. 2022 Apr 29;26:101566. doi: 10.1016/j.ajoc.2022.101566. eCollection 2022 Jun.
To report a case of infectious pediatric retinitis attributed to Rocky Mountain spotted fever which is rarely reported in the United States.
A previously healthy 14-year-old male return traveler from Mexico was admitted to the pediatric ICU with septic shock and a diffuse rash. He subsequently complained of blurry vision and was found to have evidence of retinitis on exam. Infectious workup revealed high titers of rickettsial IgM and IgG antibodies. He was treated successfully with 14 days doxycycline and followed up in clinic with improvement in his visual complaints and retinitis.
Rickettsioses are worldwide endemic zoonotic infections caused by Gram negative obligate intracellular bacteria and spread to humans by infected ticks. Rickettsial infections, including Rocky Mountain spotted fever caused by , are a cause of infectious retinitis, and atypical and zoonotic infections should remain on the differential diagnosis for patients presenting with rash, systemic illness, and visual complaints, even if the patient's travel or exposure history do not immediately suggest a likely rickettsial infection. In general, the ocular manifestations of rickettsial infection improve with systemic doxycycline treatment of the underlying infection.
报告一例由落基山斑疹热引起的儿童感染性视网膜炎病例，该病例在美国鲜有报道。
一名此前健康的14岁男性，从墨西哥回国后因感染性休克和弥漫性皮疹入住儿科重症监护病房。他随后抱怨视力模糊，检查发现有视网膜炎迹象。感染性检查显示立克次体IgM和IgG抗体滴度很高。他接受了14天的强力霉素治疗，治疗成功，随后在诊所进行随访，其视力问题和视网膜炎有所改善。
立克次体病是由革兰氏阴性专性细胞内细菌引起的全球性地方性人畜共患感染，通过受感染的蜱传播给人类。立克次体感染，包括由[具体病原体]引起的落基山斑疹热，是感染性视网膜炎的一个病因，对于出现皮疹、全身疾病和视力问题的患者，即使患者的旅行或接触史并未立即提示可能的立克次体感染，非典型和人畜共患感染仍应列入鉴别诊断。一般来说，立克次体感染的眼部表现通过对潜在感染进行全身强力霉素治疗会有所改善。
