RETINAL MANIFESTATIONS OF ACUTE MURINE TYPHUS

Purpose: To report the ocular manifestations of acute serologically co nfirmed murine typhus. Methods: A retrospective analysis of the clinic al history, photography and fluorescein angiography of two patients wi th acute murine typhus with ocular involvement was conducted. Results: A 38 year old male and a 49 year old female were included in the stud y. Both complained of fever, headache, rash, night sweats and pulmonar y symptoms. They had noted the recent onset of diminished visual acuit y and floaters. Examination of the posterior pole revealed mild optic nerve head edema (in one patient), intraretinal hemorrhages and small localized areas of retinal whitening. The history confirmed that both patients had been exposed to fleas and the serologic testing was posit ive for Rickettsia typhi. The systemic and ocular findings resolved af ter the use of systemic antibiotics. Conclusion: Rickettsial diseases such as murine typhus should be included in the differential diagnosis of otherwise healthy individuals who present with an acute systemic f ebrile illness and retinitis or neuroretinitis. Summary Statement: The clinical features of two patients with serologically proven acute mur ine typhus with ocular involvement are presented. Both patients presen ted with a retinal whitening that resolved after treatment.