Chronic papillary conjunctivitis as a novel ocular manifestation of Rickettsia felis infection: A case report.
Yue Tan, Ji Sun, Xiaoxiao Chen et al.
✦ AI-curated · Sources linked
Case in brief
A 27-year-old man presented with a 4-year history of unilateral papillary conjunctivitis that did not respond to multiple antibiotic treatments. Examination revealed significant conjunctival changes and eyelid laxity. His history of cat ownership suggested potential exposure to Rickettsia felis. Diagnosis was confirmed through metagenomic sequencing, serology, and histopathology. The patient improved significantly after a 2-month course of doxycycline and subsequent entropion repair surgery.
What made this case unusual
This case is notable for being the first documented instance of chronic papillary conjunctivitis attributed to Rickettsia felis, occurring without systemic symptoms or typical features of Parinaud's oculoglandular syndrome.
Diagnostic / clinical pearl
Clinicians should consider rickettsial infections in cases of chronic, treatment-resistant conjunctivitis, especially in patients with relevant exposure histories.
Why it matters
The case underscores the utility of metagenomic sequencing in diagnosing atypical infectious causes of ocular conditions.