Commentary: Rickettsial retinitis – Direct bacterial infection or an immune-mediated response?

Rickettsial retinitis is increasingly being reported from the Indian subcontinent.[1,2] Rickettsia has to be considered in the standard list of differential diagnosis for cases of postfever retinitis/epidemic retinitis. It is definitely controversial whether a case of epidemic retinitis is because of direct microbial invasion or an immune-mediated phenomenon. The authors of “Rickettsial retinitis: Direct bacterial infection or an immune-mediated response?” have presented a single case report of rickettsial retinitis and reported improvement after the use of oral doxycycline. The authors have also reported initial worsening with steroids and antivirals.