Roth Spots and Panuveitis in a Patient with Infectious Mononucleosis
10.3341/jkos.2018.59.6.594
- Author:
Hee Dong EOM
1
;
Jung Hyun YOON
;
Jong Jin KIM
;
Sun Jung EUM
;
Dong Ho PARK
;
Jae Pil SHIN
Author Information
1. Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea. jps11@hanmail.net
- Publication Type:Case Report
- Keywords:
Infectious mononucleosis;
Retinal hemorrhage;
Roth spots;
Uveitis
- MeSH:
Adult;
Anterior Chamber;
Cytomegalovirus;
Diagnosis;
Diagnosis, Differential;
Fever;
Hematologic Tests;
Herpesvirus 4, Human;
Humans;
Immunoglobulin M;
Infectious Mononucleosis;
Leukocytosis;
Lymphocytes;
Lymphocytosis;
Male;
Myalgia;
Ophthalmic Solutions;
Panuveitis;
Pharyngitis;
Polymerase Chain Reaction;
Retinal Hemorrhage;
Uveitis;
Visual Acuity
- From:Journal of the Korean Ophthalmological Society
2018;59(6):594-597
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To report a case of Roth spots, panuveitis, and infectious mononucleosis in a healthy adult. CASE SUMMARY: An immunocompetent 30-year-old male visited our clinic complaining of reduced visual acuity and a floating sense in both eyes of 2 days. He had experienced flu-like symptoms including fever, sore throat, myalgia, and malaise for 10 days before visual acuity decreased. His best-corrected visual acuity was 20/25 in both eyes and inflammatory cells were found in both the anterior chambers and the vitreous. Funduscopy revealed multiple retinal hemorrhages and Roth spots in both eyes. We prescribed topical steroid eye drops. A peripheral blood test revealed mild leukocytosis with lymphocytosis (60%) consisted of atypical lymphocyte (7%). Serologic examinations were positive for cytomegalovirus (CMV) immunoglobulin M (IgM) Ab and Epstein-Barr virus IgM Ab. A polymerase chain reaction for blood CMV was positive. The presumptive clinical diagnosis was Roth spots and panuveitis associated with infectious mononucleosis. Three weeks later, no inflammatory cells were apparent in the anterior chamber or vitreous. Best-corrected visual acuity had recovered to 20/20 in both eyes, and the retinal hemorrhage had completely disappeared. CONCLUSIONS: Roth spots and panuveitis can be present in patients with infectious mononucleosis, which should thus be included in the differential diagnosis of Roth spots.
