Golden Grapes

Update item information
Identifier walsh_2013_s1_c1
Title Golden Grapes
Creator Moss, Heather E; Zivin, Sean; Lin, Amy; Aakalu, Vinay; Osmanovic, Senad; Al Heeti, Omar; Mayer, Stockton; Patel, Mahesh
Subject Optic Nerve; Optic Chiasm; Abscess; Neuro-imaging
Presenting Symptom A 71 year-old African American woman presented with a painful right retrobulbar optic neuropathy and weight loss.
History A 71 year-old African American woman presented with a painful right retrobulbar optic neuropathy and weight loss. ESR was 74. She was treated with steroids. Temporal artery biopsy did not show arteritis. Nine days later, while on a steroid taper, she developed fevers, worsening right eye vision, ptosis, partial ophthalmoplegia and pain. Past medical history was remarkable for nasal septoplasty one month prior, urinary tract infection three weeks prior, hypertension, bladder cancer and diabetes complicated by retinopathy.
Clinical Visual Acuity of NLP OD and 20/30 OS, pupils equal; Right eye motility limited to small incyclotorsional and horizontal movements; Right eye complete ptosis, 2mm proptosis, trace conjunctival injection and no periorbital edema sensation was diminished in the right V1 and V2 regions.
Neuroimaging MRI
Pathology Gram stain showed gram-positive cocci in clusters. Cultures grew methicillin-sensitive Staphylococcus aureus. Anaerobic, fungal, viral and acid fast cultures were negative.
Disease/Diagnosis Staphylococcus aureusabscess of right optic nerve, chiasm and choroid
Treatment The patient has been treated with long term antibiotics.
References Attached
Relation is Part of Case presented at the NANOS 2013 Walsh Session, February 10
Contributor Primary Bruce, Beau B
Contributor Secondary Phillips, Paul H
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Date 2013-02-10
Type Text
Format application/pdf
Source 45th Annual Frank Walsh Society Meeting
Holding Institution North American Neuro-Ophthalmology Association (NANOS), Copyright 2013. For further information regarding the rights to this collection, please visit
Collection Neuro-ophthalmology Virtual Education Library: NOVEL
Language eng
ARK ark:/87278/s6128q7c
Setname ehsl_novel_fbw
ID 179151
Reference URL