Pediatric Optic Neuritis

Scrub Typhus Causing Unilateral Optic Neuritis

“…Optic neuritis in children is less common, usually bilateral and most often immune-mediated secondary to viral infection, post-immunization and demyelination [2,3]. In our case, the clinical picture, characteristic eschar, positive scrub typhus serology and an excellent response to doxycycline support a post-scrub typhus etiology as the cause of optic neuritis.…”

“…Neuroocular complications described include meningoencephalitis [3], bilateral sixth and seventh cranial nerve palsies, myoclonus [4], opsoclonus [5], polyneuropathy [5], bilateral optic neuritis [2], retinal vein occlusion and hemorrhage.…”

“…The postulated mechanism may be a postinfectious inflammatory reaction as seen in acute disseminated encephalo-myelitis [3].…”

Familial Mediterranean fever associated with optic neuritis, successfully treated with anti-interleukin 1 agents

“…In this setting, a work-up with cranial and orbital MRI, lumbar puncture and CSF studies including oligoclonal band and IgG index, and if needed further investigations for spinal MRI and neuromyelitis optica (NMO) IgG should be performed 10,11 . ON has been reported in the past with other immune mediated disorders like Behcet's disease, Sjogren's syndrome, Takayasu arteritis and systemic lupus erythematosus 9,[11][12][13][14] . Those cases might support a probable relationship between autoimmune and autoinflamatory disorders and ON.…”

“…Etiologies could be vascular, toxic/metabolic, neoplastic, infectious and noninfectious inflammatory 9 . Pathogenesis is due to an autoimmune reaction rather than the direct effect of infectious agents on optic disc.…”