Golden Grapes

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Identifier walsh_2013_s1_c1-1
Title Golden Grapes
Creator Heather E. Moss; Sean Zivin; Amy Lin; Vinay Aakalu; Senad Osmanovic; Omar Al Heeti; Stockton Mayer; Mahesh Patel
Affiliation (HE) (AL) (VA) (SO) University of Illinois at Chicago/ Department of Ophthalmology and Visual Sciences Chicago, IL; (SZ) University of Illinois at Chicago/ Department of Radiology Chicago, IL; (AL) University of Illinois at Chicago/ Department of Pathology Chicago, IL; (OA) (SM) (MP) University of Illinois at Chicago/ Department of Medicine Chicago, IL
Subject Optic Nerve; Optic Chiasm; Abscess; Neuro-imaging
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 application/pdf
Format Creation Microsoft PowerPoint
Type Text
Source 45th Annual Frank Walsh Society Meeting
Relation is Part of NANOS Annual Meeting Frank B. Walsh Sessions; 2013
Collection Neuro-Ophthalmology Virtual Education Library: Walsh Session Annual Meeting Archives: https://novel.utah.edu/Walsh/
Publisher North American Neuro-Ophthalmology Society
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management Copyright 2013. For further information regarding the rights to this collection, please visit: https://NOVEL.utah.edu/about/copyright
ARK ark:/87278/s68h1h9s
Setname ehsl_novel_fbw
ID 179149
Reference URL https://collections.lib.utah.edu/ark:/87278/s68h1h9s
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