Bilateral Uveitis Following Typhoid Fever: Case Report and Review of the Literature
Purpose: To report a case of presumed immune-mediated bilateral uveitis following infection with typhoid fever. Methods: Retrospective case report. Results: A 70-year-old Caucasian man developed typhoid fever while on vacation in Jamaica which was successfully treated with antibiotic therapy. Three weeks after onset of fever, he developed bilateral blurred vision and floaters. Clinical examination demonstrated anterior chamber cell, 1 to 2+ vitritis, and cotton wool spots bilaterally. The patient was diagnosed with postinfectious uveitis and started on prednisone 80 mg/d (1 mg/kg) which was slowly tapered by 10 mg/d/wk. By week 4 of steroid therapy, visual symptoms and evidence of intraocular inflammation had resolved. The patient successfully completed the steroid taper without recurrence of inflammation. Conclusion: Immune-mediated uveitis may occur 3 to 6 weeks following acute infection with typhoid fever. Post-typhoid uveitis is responsive to high-dose systemic steroids. Patients presenting with new-onset uveitis should be questioned for recent febrile illness or travel history.