TY - JOUR
T1 - Presumed infective meningoencephalitis complicated by bilateral optic neuritis
AU - Gore, Daniel M.
AU - Hildebrand, G. D.
AU - Sekhri, R.
AU - Nicolaides, P.
AU - Leitch, J.
PY - 2007/9
Y1 - 2007/9
N2 - PURPOSE. To report a case of presumed infective meningoencephalitis complicated by bilateral optic neuritis. METHODS. Interventional case report. RESULTS. A 7-year-old Pakistani girl presented with fever and multiple right-sided focal seizures. Despite empirical treatment with antibiotic, anti-viral and anti-tuberculous therapy for presumed infective meningoencephalitis, she further deteriorated, developing altered consciousness, hemiplegia and severe, bilateral optic neuritis. No infectious agent could be identified. Following the addition of high dose systemic corticosteroid therapy, her optic nerve function in both eyes began to recover. At 3-month follow-up, the hemiplegia had completely resolved, and visual acuity was 6/6 bilaterally with normal pupillary responses. CONCLUSIONS. This case demonstrates that meningoencephalitis of presumed infective origin may be complicated by acute, severe, bilateral optic neuritis, the latter often mediating profound visual loss. In the setting of rapidly deteriorating vision, aggressive corticosteroid treatment, with antimicrobial cover, albeit unproven, remains the mainstay of treatment.
AB - PURPOSE. To report a case of presumed infective meningoencephalitis complicated by bilateral optic neuritis. METHODS. Interventional case report. RESULTS. A 7-year-old Pakistani girl presented with fever and multiple right-sided focal seizures. Despite empirical treatment with antibiotic, anti-viral and anti-tuberculous therapy for presumed infective meningoencephalitis, she further deteriorated, developing altered consciousness, hemiplegia and severe, bilateral optic neuritis. No infectious agent could be identified. Following the addition of high dose systemic corticosteroid therapy, her optic nerve function in both eyes began to recover. At 3-month follow-up, the hemiplegia had completely resolved, and visual acuity was 6/6 bilaterally with normal pupillary responses. CONCLUSIONS. This case demonstrates that meningoencephalitis of presumed infective origin may be complicated by acute, severe, bilateral optic neuritis, the latter often mediating profound visual loss. In the setting of rapidly deteriorating vision, aggressive corticosteroid treatment, with antimicrobial cover, albeit unproven, remains the mainstay of treatment.
KW - Encephalitis
KW - Meningitis
KW - Optic neuritis
UR - http://www.scopus.com/inward/record.url?scp=38049035493&partnerID=8YFLogxK
M3 - Article
C2 - 17932871
AN - SCOPUS:38049035493
SN - 1120-6721
VL - 17
SP - 864
EP - 866
JO - European Journal of Ophthalmology
JF - European Journal of Ophthalmology
IS - 5
ER -