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Poststreptococcal keratouveitis associated with group C streptococcus pharyngitis

Authors Nataneli N, Aguilera Z, Rosenbaum PS, Goldstein T, Mayers M

Published 6 September 2011 Volume 2011:5 Pages 1257—1259


Review by Single anonymous peer review

Peer reviewer comments 2

Nathaniel Nataneli1, Zenia P Aguilera1, Pearl S Rosenbaum1, Tamar Goldstein1,2, Martin Mayers1
Department 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

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