| Identifier |
walsh_2013_s3_c5 |
| Title |
Spots, Spots Everywhere, And Not A Spot To See |
| Creator |
Sarkis M. Nazarian; Kelli Y. Shaon; Kenneth R. Habetz; Ayman Al-Salaimeh; John D. Schwankhaus; Joseph G. Chacko |
| Affiliation |
(SMN) (KRH) (AA) (JDS) (JGC) University of Arkansas for Medical Sciences, Little Rock, AR; (SMN) (AA) (JDS) (JGC) Central Arkansas Veterans Healthcare Center, Little Rock, AR; (KYS) Veterans Healthcare Center of the Ozarks, Fayetteville, AR; (KRH) Arkansas Childrens Hospital, Little Rock, AR |
| Subject |
Optic Nerve Vasculitis; Optic Neuropathy; Rocky Mountain Spotted Fever |
| History |
Additional history revealed that the patient had suffered a tick bite about two weeks prior to the onset of his rash. |
| 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 |
| 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. |
| 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. |
| Neuroimaging |
CT Scan; MRI |
| Treatment |
Corticosteroid; Lumbar Puncture; Glaucoma Eyedrops; Doxycycline |
| Date |
2013-02 |
| References |
1. Vaphiades MS. Rocky Mountain Spotted Fever as a cause of macular star figure. J Neuro-ophthalmol 2003 Dec; 23(4):276-278. 2. Dantas-Torres F. Rocky Mountain spotted fever. Lancet Infect Dis 2007 Nov; 7(11):724-732. 3. Helmick CG, Bernard KW, D'Angelo LJ. Rocky Mountain spotted fever: clinical, laboratory, and epidemiologic features in 262 cases. J Infect Dis 1984; 150:480-485. 4. Kim JH, Durack DT. Rickettsiae and the central nervous system. In Schild WM, Whitley RJ, Durack DT, editors: Infections of the Central Nervous System. New York; Raven Press 1991;411-424. 5. Vaphiades MS. Rickettsiae, Rickettsia-like organisms and the diseases they produce. In Miller NR, Newman NJ, Biousse V, Kerrison JB, editors: Walsh & Hoyt's Clinical Neuro- Ophthalmology. Philadelphia; Lippincott, Williams, and Wilkins; page 3050-3052. |
| Language |
eng |
| Format |
application/pdf |
| 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/s6ms6qdc |
| Setname |
ehsl_novel_fbw |
| ID |
179154 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6ms6qdc |
