| Identifier |
walsh_2013_s1_c1-2 |
| Title |
Golden Grapes |
| Creator |
Heather E. Moss, Sean Zivin, Amy Lin, Vinay Aakalu, Senad Osmanovic, Omar Al Heeti, Stockton Mayer, Mahesh Patel |
| 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. |
| 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 |
| 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. |
| Presenting Symptom |
A 71 year-old African American woman presented with a painful right retrobulbar optic neuropathy and weight loss. |
| Neuroimaging |
MRI |
| Treatment |
The patient has been treated with long term antibiotics. |
| Date |
2013-02 |
| References |
1. Sepahdari, Aakalu, Kapur, Michals, Saran et al, MRI of orbital cellulitis and orbital abscess: the role of diffusion-weighted imaging, AJR, 193, W244, 2009. 2. Trigui, Laabidi, Khairallah, Feki, Retinal abscess: case report of an uncommon evolution, Int Ophthalmol, 31, 327, 2011. 3. Kluytmans, van Belkum, Verbrugh, Nasal carriage of Staphylococcus aureus: epidemiology, underlying mechanism, and associated risks, Clin Microbiol Rev, 10, 505, 1997. 4. Roche, Humphreys, Smyth, Phillips, Cunney et al, A twelve-year review of central nervous system bacterial abscesses; presentation and aetiology, Clin Microbiol Infect, 9, 803, 2003. |
| Language |
eng |
| Format |
video/mp4 |
| Type |
Image/MovingImage |
| Source |
45th Annual Frank Walsh Society Meeting |
| Relation is Part of |
Case presented at the NANOS 2013 Walsh Session, February 10 |
| Collection |
Neuro-Ophthalmology Virtual Education Library - Walsh Session Annual Meeting Archives https://novel.utah.edu/Walsh/index3.html |
| Publisher |
Spencer S. Eccles Health Sciences Library, University of Utah |
| Holding Institution |
Spencer S. Eccles Health Sciences Library, University of Utah, 10 N 1900 E SLC, UT 84112-6322 |
| Rights Management |
Copyright 2013. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright |
| ARK |
ark:/87278/s6p878h5 |
| Setname |
ehsl_novel_fbw |
| ID |
179231 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6p878h5 |
