ascorbic-acid and Typhoid-Fever

A young women was treated with intravenous quinine and chloramphenicol for suspected severe malaria and/or typhoid fever. On the second day of quinine therapy (after 2.25 g of quinine) she suddenly developed total bilateral loss of vision. Both drugs were stopped and cyclandelate therapy was started. She showed slight improvement in vision but on referral her visual acuity was limited to seeing waving hand movement only; visual fields were constricted and colour vision was absent. Both pupils were fixed and dilated. The fundi showed macular oedema and attenuated retinal arteries. She was treated with dexamethasone, cyclandelate, vitamin B complex and vitamin C. Colour vision was completely recovered after 5 days of treatment. Full recovery of the direct light reflex occurred after 10 days. Visual acuity improved slowly over a period of one month to 6/15 vision in both eyes. At this time macular oedema and retinal arteriolar attenuation were still present but less severe. In the context of this case report the condition of quinine blindness is briefly reviewed and the management discussed.

Topics: Adult; Ascorbic Acid; Blindness; Chloramphenicol; Cyclandelate; Dexamethasone; Drug Therapy, Combination; Female; Humans; Infusions, Intravenous; Malaria; Ophthalmoscopy; Quinine; Referral and Consultation; Typhoid Fever; Visual Acuity; Vitamin B Complex

Topics: Adult; Anemia, Sideroblastic; Ascorbic Acid; Chloramphenicol; Female; Folic Acid; Humans; Male; Pyridoxine; Typhoid Fever; Zambia

Topics: Ascorbic Acid; Humans; Paratyphoid Fever; Riboflavin; Thiamine; Typhoid Fever

Topics: Adult; Antigens; Ascorbic Acid; Blood Glucose; Blood Protein Disorders; Body Weight; Carbon Isotopes; Cholesterol; Diet Therapy; Epinephrine; Epithelium; Fatigue; Gingival Diseases; Hemorrhage; Humans; Immunization; Insulin; Joint Diseases; Keratosis; Lipids; Male; Middle Aged; Muscular Diseases; Nutritional Requirements; Pain; Plasma; Scurvy; Time Factors; Typhoid Fever; Water

Topics: Acetylcholine; Adrenal Glands; Animals; Antibody Formation; Ascorbic Acid; Brain Stem; Cerebral Cortex; Cholesterol; Cholinesterases; Immunization; Liver; Pituitary-Adrenal System; Plasma Cells; Rats; Spleen; Typhoid Fever; Typhoid-Paratyphoid Vaccines; Vaccination

Topics: Adolescent; Adult; Ascorbic Acid; Ceruloplasmin; Copper; Dysentery, Bacillary; Hepatitis A; Humans; Middle Aged; Typhoid Fever

Topics: Adolescent; Ascorbic Acid; Body Fluids; Capillary Resistance; Child; Humans; Typhoid Fever; Typhoid-Paratyphoid Vaccines; Urine

Topics: Antibody Formation; Ascorbic Acid; Giardiasis; Helminthiasis; Typhoid Fever; Typhoid-Paratyphoid Vaccines

Topics: Ascorbic Acid; Blood; Dehydroascorbic Acid; Health; Humans; Typhoid Fever; Vitamins

Topics: Ascorbic Acid; Carbohydrate Metabolism; Humans; Typhoid Fever; Vitamins

Topics: Ascorbic Acid; Humans; Typhoid Fever; Vitamins

Topics: Ascorbic Acid; Humans; Typhoid Fever; Typhoid-Paratyphoid Vaccines; Vitamins