A case of vasculitis, retinitis and macular neurosensory detachment presenting post typhoid fever

Abstract

BackgroundOcular and extraocular immune-mediated phenomena are known to occur following febrile illness. Vasculitis, retinitis and neurosensory detachment are not well-recognized sequelae of typhoid fever.FindingsWe report a case of vasculitis, retinitis and macular neurosensory detachment presenting post typhoid fever. A 27-year-old female presented with decreased vision in right eye with history of typhoid fever (treated adequately 6 weeks prior). Her best corrected visual acuity in right eye was 20/125, N36. Fundus showed a patch of vasculitis and retinitis superior to the disc associated with macular neurosensory detachment and disc pallor. With oral steroids, the inflammation resolved and visual acuity improved to 20/20 at 6 weeks.ConclusionsImmune-mediated vasculitis and retinitis following typhoid fever may respond well to systemic steroids.

Bilateral retinitis following typhoid fever

“…In our case as the disc edema was not prominent, neuroretinitis was not considered as the diagnosis. Similar case reports by Relhan et al [6] and Laul et al [7] showed immune mediated response post typhoid fever presenting with neuroretinitis, vasculitis and macular detachment. Successful treatment with steroids was seen in them.…”

Commentary: Post fever retinitis and vasculitis: A morphological conundrum

“…Looking back at the evidence from various case series and anecdotal case reports in the literature,[ 1 2 3 4 5 6 7 ] it is evident that the morphological appearance of the disease remains the same, irrespective of the cause of the fever. These manifestations seem to be a result of an immune-mediated mechanism.…”

“…These manifestations seem to be a result of an immune-mediated mechanism. No treatment seems to be established based on the literature,[ 1 2 3 4 5 6 7 ] and patients may improve as a part of natural history.…”

Assessment of Potential Long Term Health Effects on Army Human Test Subjects of Relevant Biological and Chemical Agents, Drugs, Medications and Substances

“…Vascular changes such as telangiectasia (dilated capillaries commonly called "spider veins") and an increased number of cherry angiomas may be seen. 113 Changes in pigmentation in and around blistered areas have been noted in up to 55% on those exposed, with hyperpigmentation being more common than hypopigmentation. 114 Pigment changes are believed to be related to the degree of melanocyte injury, and pigment loss appears to be more frequent after exposure to higher doses.…”