J Korean Ophthalmol Soc > Volume 59(6); 2018 > Article
Journal of the Korean Ophthalmological Society 2018;59(6):594-597.
DOI: https://doi.org/10.3341/jkos.2018.59.6.594    Published online June 15, 2018.
Roth Spots and Panuveitis in a Patient with Infectious Mononucleosis.
Hee Dong Eom, Jung Hyun Yoon, Jong Jin Kim, Sun Jung Eum, Dong Ho Park, Jae Pil Shin
1Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, Korea. jps11@hanmail.net
2Department of Ophthalmology, Kyungpook National University Hospital, Daegu, Korea.
3Nune Eye Hospital, Daegu, Korea.
전염단핵구증에서 발생한 로트반점 및 전체포도막염 1예
엄희동1,2⋅윤정현1,2⋅김종진1,2⋅엄선정3⋅박동호1,2⋅신재필1,2
경북대학교 의과대학 안과학교실1, 경북대학교병원 안과2, 대구누네안과병원3
Correspondence:  Jae Pil Shin,
Email: jps11@hanmail.net
Received: 8 March 2018   • Revised: 12 April 2018   • Accepted: 30 May 2018
Abstract
PURPOSE
To report a case of Roth spots, panuveitis, and infectious mononucleosis in a healthy adult. CASE SUMMARY: An immunocompetent 30-year-old male visited our clinic complaining of reduced visual acuity and a floating sense in both eyes of 2 days. He had experienced flu-like symptoms including fever, sore throat, myalgia, and malaise for 10 days before visual acuity decreased. His best-corrected visual acuity was 20/25 in both eyes and inflammatory cells were found in both the anterior chambers and the vitreous. Funduscopy revealed multiple retinal hemorrhages and Roth spots in both eyes. We prescribed topical steroid eye drops. A peripheral blood test revealed mild leukocytosis with lymphocytosis (60%) consisted of atypical lymphocyte (7%). Serologic examinations were positive for cytomegalovirus (CMV) immunoglobulin M (IgM) Ab and Epstein-Barr virus IgM Ab. A polymerase chain reaction for blood CMV was positive. The presumptive clinical diagnosis was Roth spots and panuveitis associated with infectious mononucleosis. Three weeks later, no inflammatory cells were apparent in the anterior chamber or vitreous. Best-corrected visual acuity had recovered to 20/20 in both eyes, and the retinal hemorrhage had completely disappeared. CONCLUSIONS: Roth spots and panuveitis can be present in patients with infectious mononucleosis, which should thus be included in the differential diagnosis of Roth spots.
Key Words: Infectious mononucleosis;Retinal hemorrhage;Roth spots;Uveitis


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