Dengue fever-associated necrotizing scleritis: A case report with long-term follow-up

Rationale: Dengue fever is a notable emerging infectious disease that is now seen worldwide, with an estimated incidence of approximately 390 million cases per year. Although ocular complications are uncommon among dengue fever-infected patients, caution is needed to prevent vision loss. Here we report a potentially serious sight-threatening complication of dengue fever, dengue fever-associated necrotizing scleritis. Patient concerns and diagnosis: After being bitten by mosquitoes, a 60-year-old Japanese female exhibited positive serologic tests of immunoglobulin M and G enzyme immunoassays for dengue viral infection along with a decrease of leukocytes and platelets. These findings led to a dengue fever diagnosis. Slit lamp examination of her left eye revealed a conjunctival and scleral injection, elevation of the entire circumference of the sclera, and bulging of the sclera on the nasal upper side with a patch of avascular episcleral tissue. Since additional systemic examinations identified no autoimmune diseases such as rheumatism, we diagnosed the patient as dengue fever-associated scleritis. Interventions: Intensive systemic and topical steroids were administrated during the initial acute phase. Over the next 15 months, the amount of steroid was tapered off. Outcome: Initial findings for the scleritis gradually declined in response to steroid treatment. Although there was no recurrence of active scleritis, gradual thinning of the sclera continued to occur durin...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research