Two Cases of Tsutsugamushi Disease with Ocular Disease and Eschars on the Lower Eyelid.

Kim, So Young; Roh, Kyu Hwa; Jung, Moon Sun

Case Report

Journal of the Korean Ophthalmological Society 2006;47(11):1834-1839.
Published online November 30, 2006.

Two Cases of Tsutsugamushi Disease with Ocular Disease and Eschars on the Lower Eyelid.

So Young Kim, Kyu Hwa Roh, Moon Sun Jung

¹Department of Ophthalmology, Soonchunhyang University College of Medicine, Chungnam, Korea. greenizy@lycos.co.kr
²Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.

하안검의 가피와 안질환을 동반한 쯔쯔가무시병 2예

김소영^1,2,노규화¹,정문선^1,2

Department of Ophthalmology, Soonchunhyang University College of Medicine¹, Chungnam, Korea Department of Ophthalmology, Soonchunhyang University Cheonan Hospital², Cheonan, Korea

Correspondence: So Young Kim, M.D.^1,2

Abstract

PURPOSE
To report two cases of tsutsugamushi disease, showing ocular manifestations with eschars on the lower eyelids. METHODS: Two patients who have tsutsugamushi disease with ocular manifestations were examined by standard ophthalmic procedures. Eschars were observed in both patients on the medial canthal lower lid. Conjunctival injection and episcleral vessel dilations were also observed in both patients. One patient had limbal vasculitis with pannus. RESULTS: It is possible that eschars, which are the pathognomonic sign in tsutsugamushi disease, can occur on the eyelid, as well as on the axilla, perineum, abdomen, and extremities, which have been commonly observed sites. Ocular manifestations, including conjunctival injection, episcleral vessel dilation, or limbitis may be observed. These conditions may respond well to treatment with 0.1% Fluorometholone.

Key Words: Conjunctival injection;Episcleral vessel dilatation;Eschar;Pannus;Tsutsugamushi disease