Spontaneous orbital haemorrhage in purpura fulminans secondary to meningococcal septicaemia

Abstract

Eye Comment Central retinal vein occlusion is extremely rare in children. In a review of 17 patients with CRVO under the age of 40, 5 only one was in the paediatric age group. We speculate that there was an initial optic disc swelling in association with neuroretinitis which precipitated a CRVO. Solley et al 6 reviewed 24 patients with cat scratch disease, of whom 13 had unilateral disease and three were under 16 years of age. They reported one case of branch retinal vein occlusion. Epidemiological data suggest that higher cat infection rates are associated with a warm climate, fleas and kittens. Most authors advocate treatment of B. henselae with antibiotics, and Rifampicin and Doxycycline are often used. Because of the age of this patient we used Clamythromycin. There is some debate as to whether antibiotics alter long-term outcome in B. henselae associated neuroretinitis which is good in most cases. 3