Systemic infections of neuro-ophthalmic significance

Lee, Andrew G.; Brazis, Paul W.

doi:10.1016/j.ohc.2004.05.002

Cited by 4 publications

(2 citation statements)

References 66 publications

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“…8 Infections Infections Infections neuropathy Any infectious meningitis or encephalitis may lead to optic neuropathy, which could be the first manifestation of some indolent infection. 9 Neuroretinitis is associated with cat scratch disease and toxoplasmosis. Postviral optic neuritis is described with measles, mumps, chickenpox, influenza, varicella zoster and Epstein-Barr virus, and usually follow clinical infection in 1-3 weeks.…”

Section: Neurological and Ophthalmological Involvement In Waldenström...mentioning

confidence: 99%

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Angioinvasive aspergillosis mimicking giant cell arteritis in an 81-year-old man with jaw pain and vision loss

2022

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The present case report focuses on an immunocompromised 81-year-old patient initially diagnosed with Waldenström’s disease. The patient experienced a gradual vision loss and jaw pain with high erythrocyte sedimentation rate. We first suspected giant cell arteritis, despite inconclusive assessment, including a negative temporal artery biopsy. We rapidly started a corticosteroid pulse therapy followed by high-dose corticosteroid therapy that was followed even after discharge from the hospital. The patient was readmitted 20 days later with severe left retro-orbital pain and progressive left vision loss. Clinical examination revealed complete left eyelid ptosis and unilateral blindness with fixed mydriasis and no eye movement. MRI showed signs of ischaemic optic neuropathy with lysis of the left ethmoid sinus wall; thus, indicating ischaemic optic neuropathy related to lymphoplasmacytic infiltration of Waldenström’s disease (Bing-Neel syndrome). Oncological treatment of ibrutinib, a tyrosine kinase inhibitor, was then administered. Despite a favourable prognosis, no improvement was seen. An infectious aetiology was finally confirmed. The left sphenoid sinus biopsy highlighted an angioinvasive aspergillosis with rhino-orbital infiltration observed as ischaemic optic neuropathy. Oncologic treatment was discontinued and antifungal therapy with voriconazole was introduced, leading to a favourable radiological development and analgesic control, without ophtalmological improvement.

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Section: Neurological and Ophthalmological Involvement In Waldenström...mentioning

confidence: 99%

“…Any infectious meningitis or encephalitis may lead to optic neuropathy, which could be the first manifestation of some indolent infection 9. Neuroretinitis is associated with cat scratch disease and toxoplasmosis.…”

Section: Differential Diagnosismentioning

confidence: 99%