Case Report - Ophthalmology Case Reports (2026) Volume 10, Issue 1

Ocular involvement in a patient with Rickettsia typhi: Case report.

Background: A case of retinochoroiditis with vitritis with optic disc edema caused by Rickettsia typhi in a patient with previous normal eye.

Case presentation: This is case of 17-year-old female with no previous eye disease, who was referred to our ophthalmology. Patient had presented with history of fever for 5 days associated with headache. She presented with symptoms of floaters and diplopia since the onset of fever. Examination revealed 1+anterior vitreous cells, small retinal lesions and optic disc edema. Fluorescein angiography indicated mild discs hyperfluorescence, and the clinically visible round punctate lesions on optical coherence tomography showed inner retinal hyper-reflective lesion with a depth till outer plexiform layer possibly suggestive of a retinitis lesion. Laboratory tests were normal positive Rickettsia typhi serology tests, hypophosphatemia and hypovitaminosis D. Treatment included systemic doxycycline, azithromycin and prednisone, with improvement of visual acuity, ocular symptoms, optical coherence tomography abnormalities and resolution of inflammation. Oral prednisolone was discontinued, and after two months, additional improvement was seen clinically, with preserved retinal structures on optical coherence tomography.

Conclusion: This study is a case retinochoroiditis with vitritis with optic disc edema as a rare ocular presentation of Rickettsia typhi. There is need of awareness among clinicians about the ocular symptoms following systemic illness. Diagnosis relies on seroconversion, with fluorescein angiography and optical coherence tomography aiding in assessment.

Author(s):

Nagalakshmi Narayana Swamy*

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