OPHTHALMIC MANIFESTATIONS OF ROCHALIMAEA SPECIES

Rochalimaea henselae and R. quintana belong to the order Rickettsiales and are thought to be responsible for trench fever, bacillary angioma tosis, and cat scratch disease. We recently examined four patients wit h intraocular inflammation of unknown origin. Each patient had either unilateral or bilateral moderate loss of visual acuity ranging from 20 /25 to counting fingers. Bilateral intraocular inflammation manifested by anterior and posterior segment cells, retinal lesions, macular exu date, and optic nerve head swelling was present to varying degrees. Th e R. henselae to R. quintana antibody titers were greater than or equa l to 1:256 in each ease. Marked improvement in vision occurred after t reatment with either oral ciprofloxacin hydrochloride and prednisone o r doxycycline hyclate. Rochalimaea species should be considered in the differential diagnosis of intraocular inflammation and inflammatory o ptic neuropathy. Appropriate treatment may result in marked improvemen t in visual acuity.