Endogenous endophthalmitis caused by Rickettsia conorii

Purpose: We report herein the first confirmed case of endogenous endophthalmitis caused by Rickettsia conorii. Methods: Indirect immunofluorescence was performed in peripheral blood with antibodies against Rickettsia conorii. A vitreous aspirate was studied by indirect immunofluorescence with antibodies against Rickettsia conorii and by direct immunofluorescence with conjugated antigen against Rickettsia conorii. Results: Indirect immunofluorescence in peripheral blood gave a titre of 1/320 at that moment and 1/640 fifteen days later. The vitreous aspirate studied by indirect immunofluorescence gave a titre of 1/620 and it showed a positive reaction to Rickettsia conorii antigen by direct immunofluorescence. Conclusion: Rickettsia conorii should be considered in the differential diagnosis of endogenous endophthalmitis in areas where Mediterranean spotted fever is endemic.