Occlusive retinal vasculitis in an immunocompetent woman: rare presentation of ocular melioidosis

• Main Authors: Huwaina Abdul Satar, Muhammad Ikmal Mohamad Kamil, Rosiah Muda, Liza Sharmini Ahmad Tajudin
• Format: Article
• Language: English; English
• Published: Kugler Publications 2021
• Subjects: RC109-216 Infectious and parasitic diseases
• Online Access: https://eprints.ums.edu.my/id/eprint/32049/1/Occlusive%20retinal%20vasculitis%20in%20an%20immunocompetent%20woman.pdf; https://eprints.ums.edu.my/id/eprint/32049/2/Occlusive%20retinal%20vasculitis%20in%20an%20immunocompetent%20woman1.pdf; https://eprints.ums.edu.my/id/eprint/32049/; https://myjo.org/index.php/myjo/article/view/214/111; https://doi.org/10.35119/myjo.v3i3.214
• Institution: Universiti Malaysia Sabah

Burkholderia pseudomallei is a known great mimicker responsible for melioidosis. Melioidosis presents with a wide spectrum of clinical presentations in various organs including the eye. Ocular involvement in melioidosis is unusual, with eyelid and orbital infection as the commonest presentation. We describe a 41-year-old, healthy woman who complained of reduced vision in her left eye. On examination, vision in the left eye was 6/9. There was evidence of occlusive retinal vasculitis on fundoscopy examination. Fundus fluorescein angiogram showed extensive capillary fallout. Diagnosis was established by a rise in the serum antibody titre for the bacterium and further supported by clinical improvement of vision after completion of treatment antibiotics: third-generation cephalosporin and combination of amoxicillin and clavulanic acid. Sectoral panretinal photocoagulation at the capillary fallout area successfully arrested the sequelae of retinal ischaemia. Occlusive retinal vasculitis is a rare presentation of melioidosis. Early prompt diagnosis of ocular melioidosis in an immunocompetent individual helps prevent visual-related morbidity. The ability of this bacteria to cause recurrent infection in an endemic area should not be under-estimated.