| Identifier |
walsh_2013_s3_c5 |
| 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 http://library.med.utah.edu/NOVEL |
| Collection |
Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu |
| Language |
eng |
| ARK |
ark:/87278/s6ms6qdc |
| Setname |
ehsl_novel_fbw |
| ID |
179154 |
| Reference URL |
https://collections.lib.utah.edu/ark:/87278/s6ms6qdc |
