Rickettsia retinitis cases in India: a few comments.

Koushik Tripathy,Yog Raj Sharma,Rajpal Vohra,Rohan Chawla

doi:10.1186/s12348-016-0076-1

Koushik Tripathy, Yog Raj Sharma + Show 2 more

Open Access

https://doi.org/10.1186/s12348-016-0076-1

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Abstract

An important cause of infectious retinitis, not well-described in Indian literature, has been analyzed in detail systematically by Kawali A. and colleagues. However, Rickettsia retinitis (RR) was diagnosed at titres of 1:160 by the Weil–Felix test (WFT). The sensitivity and specificity of WFT at this level are poor compared to the gold standard immunofluorescent antibody assay. However, we understand that financial constraints of the Indian patients limit the availability of more definite tests. In our opinion, the optical coherence tomography features of RR described by the authors may be mimicked by other causes of retinitis, such as toxoplasma retinitis or even cotton wool spots. Infectious retinitis including RR should be treated by an antimicrobial agent with or without oral steroids until larger series or randomized controlled trials prove otherwise.

Highlights

An important cause of infectious retinitis, not well-described in Indian literature, has been analyzed in detail systematically by Kawali A. and colleagues
Weil–Felix test (WFT) may be positive in the healthy population (54 %) and patients with nonrickettsial fever (62 %) [2]
Retinitis due to other causes such as toxoplasma has been shown to involve the whole retina on optical coherence tomography (OCT) [5]

Summary

Introduction

An important cause of infectious retinitis, not well-described in Indian literature, has been analyzed in detail systematically by Kawali A. and colleagues. The authors have described an important infectious retinitis which has not been evaluated systematically in peer-reviewed literature from India. The diagnosis of Rickettsial retinitis (RR) was based on the Weil–Felix test (WFT) at titres of 1:160 or more [1].

Results

Conclusion