Recurrent chikungunya retinitis: BMJ case report
Chikungunya is a systemic viral disease transmitted to humans by infected mosquitoes that produces a sudden onset of fever, joint pains and erythematous skin eruption. A plethora of ocular manifestations have been described ranging from a non-specific conjunctivitis to exudative retinal detachment.

Ocular chikungunya seems to respond well to corticosteroid therapy, and outcomes are usually better if treated early. In the present case report, the patient acquired this infection on a travel to Mexico jungle. This was confirmed by reverse transcriptase-PCR test once she returned to the UK.

The peculiarity of the case is the inordinate delay of almost a year in the onset of eye symptoms, from acquiring the viral infection. The ocular inflammation responded to systemic corticosteroid therapy with a favourable visual outcome. She developed a recurrence many months later which again responded well to a course of oral steroids.

Learning points
• Chikungunya retinitis should be considered in the differential diagnosis of patients with focal retinitis giving a history of international travel, particularly to endemic areas.

• Oral steroid should be instituted soon, as the outcome is usually good if done early.

• Possibility of recurrence of the retinitis should be explained to the patient.

• Persistent arthralgia may be a marker of recurrence of retinitis.

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