Bilateral Chronic Peripheral Ulcerative Keratitis Secondary to Cat-Scratch Disease

Prasher, Pawan; Pascuale, Mario Di; Cavanagh, Harrison D

doi:10.1097/icl.0b013e31815788be

Cited by 9 publications

(4 citation statements)

References 6 publications

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“…It is usually unilateral. Bilateral PUK has been described in cases of sarcoidosis,3 acute myeloid leukemia,4 cat-scratch disease,5 and treatment with rituximab 6. Syphilitic involvement of the cornea is usually characterized by stromal keratitis; however, PUK in acquired syphilis is a rare entity.…”

Section: Discussionmentioning

confidence: 99%

Ocular syphilis masquerading as bilateral peripheral ulcerative keratitis

Vignesh

Srinivasan

Vijitha

2016

Taiwan Journal of Ophthalmology

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Ocular syphilis has varied manifestations in the eye. Peripheral ulcerative keratitis (PUK) is a crescent-shaped ulcer involving the peripheral cornea and associated with thinning. PUK is caused by both autoimmune and infectious diseases, such as rheumatoid arthritis, tuberculosis, and herpes. Here, we report a rare case of bilateral PUK caused by syphilis. A 55-year-old man presented with recurrent pain and redness in both eyes for 2 months. The cornea of both eyes had bilateral peripheral crescent-shaped ulcers suggestive of PUK. The patient was started on topical steroids elsewhere, but the lesion was not showing any signs of healing. A series of investigations were performed, with positive venereal disease research laboratory and fluorescent treponemal antibody absorption tests. The patient was then started on systemic penicillin, as well as topical steroids. The response to the treatment was good and the ulcer began to heal. PUK as the presenting feature of acquired syphilis is a rare scenario. Such infective causes should be managed with systemic antimicrobials for optimal outcomes.

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Section: Discussionmentioning

confidence: 99%

Ocular syphilis masquerading as bilateral peripheral ulcerative keratitis

Vignesh

Srinivasan

Vijitha

2016

Taiwan Journal of Ophthalmology

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“…Granulomatosis with polyangiitis [45,55] Polyarteritis nodosa [56] Microscopic polyangiitis [57] Eosinophilic granulomatosis with polyangiitis [58] Sarcoidosis [59--61] Behcet's disease [62] Takayasu arteritis Temporal arteritis [63,64] Leukocytoclastic vasculitis [65,66] Cryoglobulinemia [67] IgA vasculitis [57] Atypical HUS [68] Erythema elevatum diutinum [66,69] Systemic infections Herpes simplex virus (HSV) [70--72] Varicella zoster virus (VZV) [73,74] Tuberculosis (Tb) [75,76] Syphilis [77] Bartonella [78] Salmonella gastroenteritis [79] Acquired immune deficiency syndrome [ Hidradenitis suppurativa [93,94] Pityriasis rubra pilaris [95] Drug Induced Checkpoint inhibitors [96--98] Paraquat [99] Rituximab [100] Postvaccine [101] Perifosine [102] Immune reconstitution following antiretrovirals [103] Methamphetamine [104] Other autoimmune Antimyelin oligodendrocyte protein [105,106] IgG4 disease [107] Autoimmune hepatitis [108] Systemic onset juvenile idiopathic arthritis (JIA) [109] Chronic granulomatous disease [110] Local Insults: Microbial keratitis, including bacterial, fungal, viral, mycobacterial, and acanthamoeba Staphylococcal marginal keratitis Postsurgical…”

Section: Systemic Necrotizing Vasculitismentioning

confidence: 99%

Peripheral ulcerative keratitis due to systemic diseases

Sura¹,

McCallum

2022

Current Opinion in Ophthalmology

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Purpose of reviewTo discuss peripheral ulcerative keratitis, with a focus on the evaluation and management of associated systemic diseases.Recent findingsPeripheral ulcerative keratitis (PUK) is a sight-threatening condition that is often defined by the presence of a crescent-shaped area of peripheral corneal thinning, an epithelial defect, and an inflammatory corneal infiltrate. It is highly associated with rheumatoid arthritis, systemic necrotizing vasculitides like granulomatosis with polyangiitis, and collagen vascular diseases like systemic lupus erythematosus. Undertreated PUK carries a risk of vision loss and premature death.SummaryMultidisciplinary collaboration between the ophthalmologist, rheumatologist, and other consultants is required. Early and aggressive steroid-sparing therapy should be considered in cases due to noninfectious systemic disease.

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“…Cat scratch disease 65 Herpes simplex 63,66,67,68 Lyme disease 69 Herpes zoster 63,70 Fungal Viral HIV 35,37,38,39,40,41,42…”

Section: Bacterial Bacterialmentioning

confidence: 99%

Peripheral ulcerative keratitis: A review of aetiology and management

Hӧllhumer

2022

African Vision and Eye Health

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Background: Peripheral ulcerative keratitis (PUK) is a severe inflammatory disease of the peripheral cornea that can be caused by local factors or systemic inflammatory disease.Aim: The purpose of this review is to give an overview of the pathophysiology, aetiology, clinical features, diagnosis, and management of PUK.Method: A PubMed search was conducted using the keywords, ‘peripheral ulcerative keratitis’ and ‘Mooren’s ulcer’.Results: The peripheral cornea has unique characteristics the predispose to the development of PUK. These include fine capillary arcades that allow for deposition of immune complexes and subsequent activation of an inflammatory cascade with corneal melt. Several conditions have been implicated in the aetiology of PUK. The most commonly cited causes are rheumatoid arthritis (RA), granulomatosis with polyangiitis (GPA) and various dermatoses. In patients with RA, PUK usually presents in established disease, whereas in GPA, PUK may be the presenting feature in up to 60% of cases. In RA it heralds the onset of a systemic vasculitis with significant associated morbidity and mortality. The management of PUK follows an individualised stepwise approach. All patients require supportive measures to encourage healing and halt the process of keratolysis. Systemic autoimmune conditions need a systemic corticosteroid as a fast-acting agent to halt the inflammatory process while cytotoxic therapy maintains long term disease control. Failure to achieve disease control with CTT, necessitates the use of a biologic agent.Conclusion: Peripheral ulcerative keratitis is a severe inflammatory disease of the peripheral cornea that needs a thorough diagnostic workup and stepwise management approach.

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Bilateral Chronic Peripheral Ulcerative Keratitis Secondary to Cat-Scratch Disease

Abstract: This case report shows a sequential occurrence of bilateral chronic peripheral ulcerative keratitis after an episode of cat-scratch disease. Cat-scratch disease should be included in the differential diagnosis of bilateral chronic peripheral ulcerative keratitis.

Cited by 9 publications

References 6 publications

Ocular syphilis masquerading as bilateral peripheral ulcerative keratitis

Ocular syphilis masquerading as bilateral peripheral ulcerative keratitis

Peripheral ulcerative keratitis due to systemic diseases

Peripheral ulcerative keratitis: A review of aetiology and management

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