Author(s)

Ermira Muco^1*, Arta Kushi¹, Neada Hoxha¹, Anila Monka², Ali Tonuzi², Majlinda Kota³, Artan Bego³, Dhimiter Kraja¹

¹Department of Infectious Diseases, University Hospital Center “Mother Tereza”, Tirana, Albania.
²Department of Ophthalmology, University Hospital Center “Mother Tereza”, Tirana, Albania.
³Institute of Public Health, Tirana, Albania.

We describe a case of Mediterranean spotted fever complicated with thrombosis of the left central retinal vein. A 41-year-old woman patient living in the city Scodra was referred to our hospital in October 2017 for high fever 40°C, muscular and articular pains, severe headache, maculopapular rash, chills, photophobia and visual loss in his left eye. Ocular examination showed vision acuity: OD 8/10, OS 2/10. Funduscopic examination complemented with fluorescein angiography showed: optic nerve papilla with clear contours, diffuse hemorrhages in the contest off retinal vein thrombosis, white retinal lesions, vascular sheathing and macular cystoids edema. R. conorii antibodies were identified by ELISA anti Rickettsia conorii IgM, IgG and Weil-Felix Ox-19 test. Investigation of other infective agents and the immunological panel were negative. After treatment with doxycycline 200 mg/day for 10 days vision acuity was OD: 8/10 OS: 6/10; FO: There are less hemorrhages in fluorescein angiograph and OCT showed a reduced macular cystoids edema. Mediterranean spotted fever should be considered in the differential diagnosis of a patient who presents with an acute febrile disease accompanied by maculopapular rash especially in the seasons of spring, summer or autumn.

Mediterranean Spotted Fever, Rickettsia conorii, Thrombosis, Central Retinal Vein

Muco, E. , Kushi, A. , Hoxha, N. , Monka, A. , Tonuzi, A. , Kota, M. , Bego, A. and Kraja, D. (2018) Mediterranean Spotted Fever Complicated with Thrombosis of the Left Central Retinal Vein: A Case Report and Literature Review. Journal of Biosciences and Medicines, 6, 69-75. doi: 10.4236/jbm.2018.64005.