쯔쯔가무시병에서 발생한 전포도막염 1예
Case of Tsutsugamushi Disease With Anterior Uveitis
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목적: 전포도막염과 상안검에 가피를 동반한 쯔쯔가무시병 환자 1예를 보고하고자 한다. 증례요약: 56세 여자환자가 우안의 통증과 점진적인 시력저하를 주소로 내원하였다. 전신검사상 우측 목부위의 림프절이 촉진되었고 이마와 윗눈꺼풀 부위에 가피가 관찰되었다. 세극등검사상에서 우안결막충혈과 상공막혈관의 확장이 보였으며 심한 전방 염증이 관찰 되었다. 안저검사상 특이소견은 없었다. 진단을 위해 내과에 혈액검사를 의뢰하였으며 쯔쯔가무시 병으로 확진되었다. 환자 눈상태는 스테로이드 치료에 대해 반응을 보여 3주 후 안과적 검사상 호전되었고 6개월 후의 추적진료상에서도 정상이었다. 결론: 쯔쯔가무시병으로 결막염, 윤부염등은 보고된바 있으나 전포도막염을 동반한 경우는 그동안 보고된바가 없었다. 전포도막염은 전신상태 호전과 함께 스테로이드에 반응하였다.
Abstract
Purpose: To report a single case of tsutsugamushi disease with anterior uveitis and eschars on the upper eyelid. Case summary: A 56-year-old female patient complained of ocular pain and gradually decreasing visual acuity in her right eye. On physical examination, lymphadenopathy was palpable on the right side of the neck, and eschars were observed on the forehead and upper eyelid. On slit lamp examination, conjunctival injection, episcleral vessel dilations and severe intraocular inflammatory reaction were observed. Fundus examination showed no abnormal findings. A blood test was submitted for analysis, and tsutsugamushi disease was diagnosed. The patient’s ocular manifestations responded well to treatment with steroids. After three weeks, the patient showed improvement on ocular examination, and no problems were observed at the six-month follow-up. Conclusions: Although ocular manifestation of tsutusgamushi disease with conjunctivitis and limbitis has previously been reported, ocular manifestation of tsutusgamushi disease with anterior uveitis has not been reported. Anterior uveitis may respond satisfactorily to steroid treatment, along with improvement in systemic conditions.
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