Abstract
BackgroundPoststreptococcal syndrome (PSS) can be a consequence of nonpurulent primary infection with group A streptococci (GAS). Postreptococcal uveitis is a well recognized entity with quite a few descriptions in the literature, but so far no conjunctival involvement has been reported.The aim of the study is to present a rare case of postreptococcal conjunctival lesions mimicking a lymphoma.Case presentation19-years-old Caucasian female presented with pink, nodular infiltrates in the right conjunctiva that occurred a few months after upper respiratory tract infection and tonsillectomy. Histopathological examination of collected lesion samples revealed inflammatory reaction with lymphocytes proliferation and failed to rule out a myeloma. Complementary flow-cytometry did not show monoclonal proliferation of lymphocytes B. During follow-up we observed the complete regression of conjunctival lesions after the benzyl penicillin treatment prescribed by ENT specialist due to elevated plasma ASO levels. Therefore, we suppose that those lesions must have represented a part of poststreptococcal syndrome.ConclusionsTo conclude, this is, to the best of our knowledge, the first report of conjunctival involvement in the course of PSS related to group A streptococci.
Highlights
Poststreptococcal syndrome (PSS) can be a consequence of nonpurulent primary infection with group A streptococci (GAS)
To conclude, this is, to the best of our knowledge, the first report of conjunctival involvement in the course of PSS related to group A streptococci
Poststreptococcal syndrome (PSS) is a sterile inflammation thought to represent an autoimmune reaction between streptococcus-sensitized lymphocytes and host tissue because of ‘molecular mimicry’
Summary
Poststreptococcal syndrome (PSS) is a sterile inflammation thought to represent an autoimmune reaction between streptococcus-sensitized lymphocytes and host tissue because of ‘molecular mimicry’. The patient reported the appearance of painless reddish nodules on the right bulbar conjunctiva couple weeks previously. The patient didn’t have past ocular history of note Her past medical history revealed history of purulent tonsillitis treated with systemic antibiotic therapy a year earlier. After this treatment the levels of antistreptolysin (ASO) were. The patient was otherwise healthy with no travelling history and reported no coincidence between the appearance of conjunctival lesions and tonsillitis. On biomicroscopy there were numerous, pink and reddish nodules on the right bulbar conjunctiva nasally and temporally [Figure 1A and B]. Those lesions seemed to be tightly fixed to the sclera. At the follow-up in 6 weeks time the conjunctival lesions had completely disappeared
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