Uveoparotid Fever as a Manifestation of Mikulicz's Syndrome

Abstract

During 1905 and 1906, Heerfordt had the opportunity of observing three patients in the Copenhagen City Hospital, each of whom presented so similar and so striking a clinical picture that in 1909 he ventured to describe the condition as a hitherto unrecognized clinical entity. There were three essential and outstanding features in these cases : enlargement of the parotid glands lasting several months and thus running a relatively chronic course in contrast with the acute swelling in epidemic parotitis ; an ocular inflammation involving the uveal tract, and a long continued fever of low degree corresponding with the subchronic course of both the iridocyclitis and the parotitis. In two of the three patients there were cerebrospinal paralyses. For this symptom-complex, Heerfordt proposed the descriptive title febris uveoparotidea subchronica, thus emphasizing the three chief characteristics and the course of the disorder.Heerfordt's 1 communication was followed by numerous case reports of a similar nature and provoked much discussion of interest and value to both internists and ophthalmologists. It is curious to note that these contributions are chiefly German and Scandinavian. Rarely is there an English report, and only once is there an American reference to the disorder which, in the literature, either bears the originally proposed title or is alluded to as Heerfordt's disease or simply, uveoparotitis.As the disorder has received such scant attention in this country, and since its recognition needs to be stimulated and attention drawn to the spectacular effect of radiotherapy on the parotid tumor as well as on the ocular lesion, the following case of Heerfordt's syndrome is reported. REPORT OF A CASEHistory.-W. S.,2 a white boy, aged 12, was admitted to the Harriet Lane Home on March 27, 1923, because of "sore, red eyes, fever and enlarged glands."There was no family history of tuberculosis. With the exception of the usual diseases of childhood, the patient had enjoyed excellent health until the onset of the present disorder. Two years previously, he had had an attack of mumps.

Ocular Sarcoidosis

“…A positive complement-fixation test for tuberculosis was obtained in only 27.3% of sarcoid patients, and it was found that this was almost exactly the figure which could be accounted for by old or latent tuberculo¬ sis in these patients. 7. A strong argument against a tuber¬ culous etiology is the use of the hemagglutination reaction of Middlebrook and Dubos to detect antibodies to some fraction of the tubercle bacilli present in the serum of patients.…”