Ralph Yachoui1. 1. Division of Rheumatology, Department of Medicine, Marshfield Clinic, Marshfield, Wisconsin.
Abstract
PURPOSE: To describe clinical, laboratory, and funduscopic data of a patient presenting with newly diagnosed adult-onset Still disease and Purtscher-like retinopathy. METHODS: Observational case report. PATIENT: A 43-year-old man presented with a 3-week history of daily high-spiking fever, diffuse arthralgia and myalgia, sore throat, and a transient nonpruritic maculopapular rash. Two weeks from the onset of his illness, he developed a gradual decrease in visual acuity in both eyes. Fundoscopic examination showed multiple areas of retinal whitening, discrete superficial retinal hemorrhages, and few characteristic Purtscher flecken in the left eye. RESULTS: The patient was diagnosed with adult-onset Still disease. We used high-dose corticosteroid therapy with complete resolution of adult-onset Still disease, but it was ineffective for recovery of vision. CONCLUSION: Clinicians should be aware of Purtscher-like retinopathy as a severe ophthalmic complication of adult-onset Still disease.
PURPOSE: To describe clinical, laboratory, and funduscopic data of a patient presenting with newly diagnosed adult-onset Still disease and Purtscher-like retinopathy. METHODS: Observational case report. PATIENT: A 43-year-old man presented with a 3-week history of daily high-spiking fever, diffuse arthralgia and myalgia, sore throat, and a transient nonpruritic maculopapular rash. Two weeks from the onset of his illness, he developed a gradual decrease in visual acuity in both eyes. Fundoscopic examination showed multiple areas of retinal whitening, discrete superficial retinal hemorrhages, and few characteristic Purtscher flecken in the left eye. RESULTS: The patient was diagnosed with adult-onset Still disease. We used high-dose corticosteroid therapy with complete resolution of adult-onset Still disease, but it was ineffective for recovery of vision. CONCLUSION: Clinicians should be aware of Purtscher-like retinopathy as a severe ophthalmic complication of adult-onset Still disease.