Spots, Spots Everywhere, And Not A Spot To See

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Identifier walsh_2013_s3_c5-1
Title Spots, Spots Everywhere, And Not A Spot To See
Creator Nazarian, Sarkis M; Shaon, Kelli Y; Habetz, Kenneth R; Al-Salaimeh, Ayman; Schwankhaus, John D; Joseph G. Chacko, M.D., University of Arkansas
Subject Optic Nerve Vasculitis; Optic Neuropathy; Rocky Mountain Spotted Fever
Presenting Symptom A 58-year old man presented to the Eye Clinic at his local Hospital after his private Ophthalmologist found bilateral optic nerve edema as the cause of his sudden, painless binocular vision loss.
History Additional history revealed that the patient had suffered a tick bite about two weeks prior to the onset of his rash.
Clinical Erythematous rash that started on his back, spread centrifugally into his extremities, sparing his palms and soles, a couple of weeks before his vision declined. He had concurrent headache, fever, and generalized malaise. The rash had been diagnosed as a heat rash due to exposure to extreme heat while working on his farm.
Neuroimaging CT Scan; MRI
Pathology Rocky Mountain Spotted Fever (RMSF) titers were obtained; IgG by EIA was positive; confirmation by IFA was positive at 1:64 dilution. A week later, RMSF IgG IFA titer was positive at 1:256 dilution. Laboratory studies to rule out NMO (Neuromyelitis Optica), vasculitis, lupus, sarcoidosis, toxoplasmosis, syphilis, Brucellosis, Ehrlichiosis, etc. were all negative.
Disease/Diagnosis Optic neuropathy due to Rocky Mountain Spotted Fever
Treatment Corticosteroid; Lumbar Puncture; Glaucoma Eyedrops; Doxycycline
References Attached
Relation is Part of Case presented at the NANOS 2013 Walsh Session, February 10
Contributor Primary Bhatti, M Tariq
Contributor Secondary Thurtell, Matthew J
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/s61v8bk7
Setname ehsl_novel_fbw
ID 179174
Reference URL