CHIKUNGUNYA-ASSOCIATED UVEITIS AND EXUDATIVE RETINAL DETACHMENT: A CASE REPORT.

Abstract

PURPOSE:

To report the first known case of bilateral granulomatous panuveitis secondary to chikungunya fever in the United States, acquired by a U.S. citizen traveling from an endemic region.

METHODS:

Case report.

RESULTS:

A 47-year-old woman presented with 10 days of bilateral decreased vision and photophobia concurrent with a febrile illness contracted while visiting the Dominican Republic. She presented with bilateral granulomatous panuveitis and exudative retinal detachments. Extensive workup was negative with the exception of positive chikungunya virus immunoglobulin G and immunoglobulin M titers. Initially, she responded to corticosteroid treatment but developed recurrent inflammation 3 months after completing the initial treatment. Immunomodulatory therapy was initiated at the time of recurrence, and with immunomodulatory therapy alone her inflammation has been controlled for 6 months.

CONCLUSION:

The prevalence of chikungunya fever-related uveitis is increasing with the recent epidemics throughout the Americas. Inflammation can occur during the febrile illness or months later and can manifest in a variety of ways. Posterior segment inflammation is more commonly a delayed presentation. Previous reports suggest that chikungunya fever-related uveitis responds well to corticosteroid therapy. This is the first reported case of recurrent inflammation. Given the wide variety of presentations, chikungunya fever-related uveitis should be included in the differential diagnosis of all at-risk patients presenting with acute ocular inflammation, particularly those traveling from endemic regions.

• Authors: Nicole K Scripsema, Emile Sharifi, C Michael Samson, Sanjay Kedhar, Richard B Rosen
• Journal: Retinal cases & brief reports (Retin Cases Brief Rep) Vol. 9 Issue 4 Pg. 352-6 ( 2015) ISSN: 1937-1578 [Electronic] United States
• PMID: 26421893 (Publication Type: Case Reports, Journal Article)

Topics

• Chikungunya Fever (complications)
• Exudates and Transudates
• Female
• Granuloma (etiology)
• Humans
• Middle Aged
• Panuveitis (etiology)
• Retinal Detachment (etiology)