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TitleLeptospirosis related uveitis–the first case report in Taiwan
PurposeWe presented a case with leptospirosis-related uveitis which was the first case report in Taiwan.
MethodsCase report
ResultsA 55-year-old male suffered from bilateral blurred vision for 4 days. Slit-lamp exam showed 3+ cells in anterior chamber and fine keratic precipitates in his left eye and 1+ cells in anterior chambers in his right eye. The initial intraocular pressure were 15.5 and 20 mmHg in his right and left eye. The visual acuity of his left eye was 20/100. The fundus exam revealed cloudy vitreous with vasculitis in his left eye. Fluorescein angiography showed peripapillary hyperfluorescence. The patient was negative for HLA-B27, HLA-B51 and syphilis. Other causes of uveitis were surveyed and all showed negative results. Tracing back his history, he ever admitted due to sepsis with thrombocytopenia, acute renal failure and jaundice 1 year ago. Serology test examined by the CDC, Taiwan revealed four-fold elevation of leptospiral microscopic agglutination test. Leptospirosis related multi-organ dysfunction was diagnosed, and he recovered after systemic antibiotics. Thus, leptospiral uveitis was impressed and the visual acuity recovered to 20/20 in both eyes 3months later after topical and systemic steroids were administrated.
Conclusion Ocular leptospirosis is potentially underdiagnosed in Taiwan due to a prolonged symptom-free period between the systemic and ocular manifestations, and the inconvenience of confirming laboratory support. Thorough history taking may aid in diagnosis. To our knowledge, this is the first documented case of leptospiral uveitis in Taiwan.
Conflict of interestNo
Authors 1
Last nameLIN
Initials of first name(s)HC
DepartmentKaohsiung Medical University Hospital (KMUH)
CityKaohsiung (KHH)
Authors 2
Last nameCheng
Initials of first name(s)WH
Authors 3
Last nameKao
Initials of first name(s)CC