Two Cases of Tsutsugamushi Disease with Ocular Disease and Eschars on the Lower Eyelid

ABSTRACT

PURPOSE: To report two cases of tsutsugamushi disease, showing ocular manifestations with eschars on the lower eyelids. METHODS: Two patients who have tsutsugamushi disease with ocular manifestations were examined by standard ophthalmic procedures. Eschars were observed in both patients on the medial canthal lower lid. Conjunctival injection and episcleral vessel dilations were also observed in both patients. One patient had limbal vasculitis with pannus. RESULTS: It is possible that eschars, which are the pathognomonic sign in tsutsugamushi disease, can occur on the eyelid, as well as on the axilla, perineum, abdomen, and extremities, which have been commonly observed sites. Ocular manifestations, including conjunctival injection, episcleral vessel dilation, or limbitis may be observed. These conditions may respond well to treatment with 0.1% Fluorometholone.