Ocular Brucellosis: Case Report and Literature Review

Abstract

Brucellosis is a systemic zoonotic infection transmitted to humans by contact with the body fluids of infected animals or consumption of infected animal products. Although nearly eradicated in many developed countries, the disease is still endemic in Middle and South America, Central Asia, the Arabian Peninsula, Middle East, and Mediterranean regions. Any organ or system of the body may be involved. Skeletal system, spleen, liver, and bone marrow are the most frequently affected sites. Ocular involvement is reported relatively rarely, in 3.4%-26% of brucellosis cases, usually as a complication of chronic phases of the disease. Although ocular complications have been known since the early 20th century, decades after recognition of the disease, there is no convincing data about its true incidence, as most citations in the literature refer to case reports. Ocular brucellosis has severe complications and may result in total loss of vision in a quarter of patients despite appropriate treatment. A literature search conducted in PubMed on 10 September 2018 using the keywords "ocular-brucellosis" and "uveitis-brucellosis" and limiting to only human studies in the English literature published after 1950 yielded 27 and 29 articles, respectively. Of these, 14 were case reports or case series and included a total of 131 cases. We also found five case reports by searching for "oküler-brusella" and "göz-brusella", two in the Turkish Medline database (www.turkmedline.net) and four in Google search, with a total of six cases. Herein, we describe a case of ocular involvement of chronic brucellosis presenting with chorioretinitis that led to severe visual loss, and present a systematic review of previous cases reports and series in the literature. We believe that in an endemic area such as our country, routine ophthalmologic evaluation of all patients diagnosed with brucellosis and immediate initiation of therapy are necessary to prevent disease progression and severe sequelae.

Keywords

• Glaucoma
• dacryoadenitis
• ocular involvement
• ophthalmologic
• optic neuritis