Anterior and Intermediate Uveitis with Retinal Vasculitis: An Unusual Manifestation of Post-Streptococcal Uveitis Syndrome

Ocul Immunol Inflamm. 2016 Dec;24(6):607-609. doi: 10.3109/09273948.2015.1094094. Epub 2015 Dec 29.

Abstract

Purpose: To report a case of bilateral panuveitis with vasculitis, an unusual manifestation of post-streptococcal uveitis syndrome (PSU).

Methods: An 8-year-old patient consulted for bilateral red eye following acute tonsillitis. Exploration revealed bilateral anterior uveitis, vitritis, macular edema, and Frosted Branch Angiitis. Given a clinical suspicion of PSU, blood and serology tests were performed to rule out other causes of vasculitis and retinitis.

Results: Serologies came back negative except for highly elevated antistreptolysin-O titers. Topical and oral corticosteroids normalized the patient's visual acuity and clinical findings within a few weeks. A subsequent anterior-only recurrence was successfully resolved with topical treatment.

Conclusions: Although PSU most commonly manifests as anterior uveitis, it may present with involvement of the posterior pole. To achieve a correct diagnosis, clinical suspicion and assessment of antistreptolysin-O titers as well as ruling out other conditions with similar clinical features are the mainstay approaches to diagnosis. Prognosis is generally good.

Keywords: Panuveitis; post-streptococcal; tonsillitis; uveitis; vasculitis.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Antistreptolysin / blood
  • Child
  • Humans
  • Macular Edema / diagnosis
  • Macular Edema / drug therapy
  • Macular Edema / etiology
  • Retinal Vasculitis / diagnosis*
  • Retinal Vasculitis / drug therapy
  • Retinal Vasculitis / etiology*
  • Streptococcal Infections / complications*
  • Treatment Outcome
  • Uveitis, Anterior / diagnosis*
  • Uveitis, Anterior / drug therapy
  • Uveitis, Anterior / etiology*
  • Uveitis, Intermediate / diagnosis*
  • Uveitis, Intermediate / drug therapy
  • Uveitis, Intermediate / etiology*
  • Vasculitis / diagnosis
  • Vasculitis / drug therapy
  • Vasculitis / etiology

Substances

  • Adrenal Cortex Hormones
  • Antistreptolysin