trimethoprim--sulfamethoxazole-drug-combination and Optic-Neuritis

Neuroretinitis is a clinical entity usually seen in young healthy adults, that is characterized by rapid profound unilateral loss of vision and includes optic nerve head edema, splinter hemorrhages, macular exudate in a stellate pattern, and variable vitreous inflammation. There are numerous entities that can cause a picture of neuroretinitis ranging from vascular to infectious to autoimmune.. We report two patients with neuroretinitis, who presented with unilateral blurred vision and had serologic evidence of Toxoplasma gondii infection.. Both patients responded well to treatment with systemic antibiotics and corticosteroids. Visual acuity returned to 20/60 in one patient and 20/20 in the other.. Although the etiology is usually idiopathic, infectious causes of neuroretinitis, including toxoplasmosis, should be kept in mind in order to maintain visual acuity by early diagnosis and appropriate therapy.

Topics: Animals; Antibodies, Protozoan; Antiprotozoal Agents; Child; Drug Therapy, Combination; Female; Fluorescein Angiography; Humans; Male; Middle Aged; Optic Neuritis; Prednisolone; Retinitis; Toxoplasma; Toxoplasmosis, Ocular; Trimethoprim, Sulfamethoxazole Drug Combination; Visual Acuity

Topics: Adult; Anti-Bacterial Agents; Antibodies, Bacterial; Bartonella henselae; Bartonella quintana; Cat-Scratch Disease; Child; Doxycycline; Eye Infections, Bacterial; Female; Fluorescein Angiography; Fundus Oculi; Humans; Immunoglobulin G; Immunoglobulin M; Optic Disk; Optic Neuritis; Trimethoprim, Sulfamethoxazole Drug Combination

Cat scratch disease is a subacute regional lymphadenitis usually preceded by a history of being scratched by a cat or young kitten. The spectrum of illness ranges from mild self-limited adenopathy to severe systemic disease, including hepatosplenomegaly, encephalopathy, osteolytic lesions, splenic abscesses, mediastinal masses, and neuroretinitis. Vision loss is a rare complication of the disease. The authors report a patient with cat scratch disease associated with acute febrile illness, lymphocytic meningitis, and acute vision loss secondary to neuroretinitis. To their knowledge, this is the first ophthalmic case reported in which the diagnosis is supported by both a positive skin test and positive histopathology.

Topics: Cat-Scratch Disease; Child; Dexamethasone; Female; Fundus Oculi; Humans; Optic Neuritis; Retinitis; Skin Tests; Trimethoprim, Sulfamethoxazole Drug Combination; Vision Disorders; Visual Acuity