Poststreptococcal keratouveitis associated with group C streptococcus pharyngitis

Nathaniel Nataneli¹, Zenia P Aguilera¹, Pearl S Rosenbaum¹, Tamar Goldstein^1,2, Martin Mayers^1
1Department of Ophthalmology, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY, USA; ²Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel

Purpose: To report the first case of poststreptococcal syndrome uveitis (PSU) in association with group C streptococcus (GCS).
Patients and methods: Chart review of a 24-year-old man who presented with bilateral ocular redness, pain, and photophobia for 5 days and "white rings" around his eyes for a duration of 3 days. The patient further reported fever and sore throat in the preceding week. Slit-lamp examination showed bilateral keratouveitis. A thorough uveitis workup, antistreptolysin O (ASLO) titer, and throat culture were obtained. The patient was treated with frequent topical steroids and systemic doxycycline. The uveitis and keratitis subsided over the next few weeks, leaving extensive peripheral keratolysis.
Results: The results of laboratory diagnostic testing revealed an elevated ASLO, C-reactive protein, as well as HLA-B27 positivity. Throat cultures grew beta-hemolytic GCS; group A streptococcus was culture negative.
Conclusion: GCS pharyngitis may be a causative organism of PSU.

Keywords: pharyngitis, keratolysis, keratouveitis