Panophthalmitis in a patient with dengue fever

Kumar, Amit; Deorari, Vaibhav; Swaroop, Shekhar; Biswas, Ashutosh

doi:10.1136/bcr-2019-229588

Cited by 7 publications

(4 citation statements)

References 7 publications

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“…Kumar et al . [ 12 ] reported a case of panophthalmitis in a patient with dengue fever who subsequently developed intracranial abscesses. The authors postulated that the condition occurred due to a dysregulated immunological response which could have targeted the eye antigens and led to the inflammation of all layers of the eyeball.…”

Section: Discussionmentioning

confidence: 99%

Evidence of dengue virus in eviscerated specimens of panophthalmitis secondary to dengue fever: A possible cause-effect phenomenon

Dave

Sharma

Lakshmi

et al. 2022

Indian J Ophthalmol

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Purpose: To report a retrospective series of three cases of infectious panophthalmitis post-dengue fever with ex vivo confirmation of dengue virus ribonucleic acid (RNA) in the tissues of the eye. Methods: Four eyes of three patients, who were diagnosed with panophthalmitis following dengue fever and who underwent evisceration, were included. All demographic and clinical data were recorded. The eviscerated samples were subjected to direct microscopy, culture for bacteria, fungi, and parasites, and molecular virology (dengue virus [DENV] NS1-specific reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay). Results: The time from the development of dengue fever to the occurrence of ocular symptoms was 4.33 ± 1.15 (median 5) days. DENV NS1 RNA, suggestive of the presence of the dengue virus, was confirmed in all evisceration specimens (uveal tissue, cornea). All the patients recovered completely from dengue fever and on follow-up had healthy eviscerated sockets. Conclusion: Demonstration of the DENV RNA in the eviscerated specimens of panophthalmitis following dengue fever implicates the DENV in the pathophysiology of the ocular infection.

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Section: Discussionmentioning

confidence: 99%

Evidence of dengue virus in eviscerated specimens of panophthalmitis secondary to dengue fever: A possible cause-effect phenomenon

Dave

Sharma

Lakshmi

et al. 2022

Indian J Ophthalmol

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“…In addition to the most common findings, DENV infections can present with a wide range of other ocular features. A recent (2021) case series with 23 patients reported panophthalmitis, endophthalmitis, orbital cellulitis with panophthalmitis, and orbital haemorrhage with panophthalmitis in 10, 11, 4, and 1 patient(s), respectively 58,90 . Vascular occlusions and vitreous haemorrhages are uncommon posterior segment findings in dengue patients 42,91 .…”

Section: Clinical Features Of Dengue Eye Diseasementioning

confidence: 98%

“…A recent (2021) case series with 23 patients reported panophthalmitis, endophthalmitis, orbital cellulitis with panophthalmitis, and orbital haemorrhage with panophthalmitis in 10, 11, 4, and 1 patient(s), respectively. 58,90 Vascular occlusions and vitreous haemorrhages are uncommon posterior segment findings in dengue patients. 42,91 They represent an enhanced immune response, as the DENV NS1 antigen can cause endothelial cell monolayer rupture mediated by the inflammatory cytokines produced via TLR 4 activation of macrophages and human PBMCs.…”

Section: Other Ocular Manifestationsmentioning

confidence: 99%

Dengue fever ophthalmic manifestations: A review and update

Lucena‐Neto

Falcão

Moraes

et al. 2023

Reviews in Medical Virology

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Dengue fever, the most common arbovirus disease, affects an estimated 390 million people annually. Dengue virus (DENV) is an RNA virus of the Flaviviridae family with four different serotypes. Dengue haemorrhagic fever is the deadliest form of dengue infection and is characterised by thrombocytopaenia, hypotension, and the possibility of multi-system organ failure. The mechanism hypothesised for DENV viral replication is intrinsic antibody-dependent enhancement, which refers to Fcγ receptor-mediated viral amplification. This hypothesis suggests that the internalisation of DENV through the Fcγ receptor inhibits antiviral genes by suppressing type-1 interferon-mediated antiviral responses. DENV NS1 antibodies can promote the release of various inflammatory mediators in the nuclear transcription factor pathway (NF-κB-dependent), including monocyte chemoattractant protein (MCP)-1, interleukin (IL)-6, and IL-8. As a result, MCP-1 increases ICAM-1 expression and facilitates leukocyte transmigration. In addition, anti-DENV NS1 antibodies induce endothelial cell apoptosis via a nitric oxide-regulated pathway. A chain reaction involving pre-existing DENV heterotypic antibodies and innate immune cells causes dysfunction in complement system activity and contributes to the action of autoantibodies and anti-endothelial cells, resulting in endothelial cell dysfunction, bloodretinal barrier breakdown, haemorrhage, and plasma leakage. A spectrum of ocular diseases associated with DENV infection, ranging from haemorrhagic to

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“…1 2 3 27 40 41 Panophthalmitis and anterior segment manifestations including anterior uveitis and stromal keratitis are less common. 42 43 …”

Section: R Esultsmentioning

confidence: 99%

Ocular manifestations of emerging arthropod-borne infectious diseases

et al. 2021

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Purpose: To review the clinical features, diagnosis, treatment modalities, and prognosis of arthropod-borne infectious diseases. Methods: This is a narrative review on arthropod-borne infectious diseases including general and ophthalmological aspects of these infectious diseases. A comprehensive literature review between January 1983 and September 2020 was conducted in PubMed database. Epidemiology, clinical features, diagnosis, treatment, and prognosis of arthropod-borne infectious diseases were reviewed. Results: Emergent and resurgent arthropod-borne infectious diseases are major causes of systemic morbidity and death that are expanding worldwide. Among them, bacterial and viral agents including rickettsial disease, West Nile virus, Dengue fever, Chikungunya, Rift valley fever, and Zika virus have been associated with an array of ocular manifestations. These include anterior uveitis, retinitis, chorioretinitis, retinal vasculitis, and optic nerve involvement. Proper clinical diagnosis of any of these infectious diseases is primarily based on epidemiological data, history, systemic symptoms and signs, and the pattern of ocular involvement. The diagnosis is confirmed by laboratory tests. Ocular involvement usually has a self-limited course, but it can result in persistent visual impairment. Doxycycline is the treatment of choice for rickettsial disease. There is currently no proven specific treatment for arboviral diseases. Prevention remains the mainstay for arthropod vector and zoonotic disease control. Conclusions: Emerging arthropod vector-borne diseases should be considered in the differential diagnosis of uveitis, especially in patient living or with recent travel to endemic countries. Early clinical diagnosis, while laboratory testing is pending, is essential for proper management to prevent systemic and ocular morbidity.

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Panophthalmitis in a patient with dengue fever

Cited by 7 publications

References 7 publications

Evidence of dengue virus in eviscerated specimens of panophthalmitis secondary to dengue fever: A possible cause-effect phenomenon

Evidence of dengue virus in eviscerated specimens of panophthalmitis secondary to dengue fever: A possible cause-effect phenomenon

Dengue fever ophthalmic manifestations: A review and update

Ocular manifestations of emerging arthropod-borne infectious diseases

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