Bilateral optic nerve infiltration in tuberculous meningitis: A diagnostic dilemma

• 来源期刊: 急性病杂志（英文版）
• 年，卷（期）: 2021,（2）
• 所属期刊栏目: Case Reports
• 页码范围: 87-90
• 页数: 4页
• 语种: 英文
• DOI: 10.4103/2221-6189.312216

摘要

Rationale: Tuberculous meningitis (TBM) is severe extrapulmonary tuberculosis that can cause poor outcomes without timely treatment. We report a case of presumed TBM that presented solely ocular complaints without other neurological features.Patient's concerns: A 71-year-old man presented with a sudden central visual defect in both eyes for 10 days. Fundoscopy showed bilateral hyperaemic swelling disc with infiltrates. Diagnosis: A diagnosis of presumptive TBM was made with Mantoux test reading 15 mm, elevated erythrocyte sedimentation rate, subdural effusion on CT scan, and high opening pressure. Intervention: Anti-tuberculous treatment. Outcomes: Bilateral vision improved and optic discs swelling resolved. Lessons: Early recognition of TBM with optic nerve infiltration is crucial for prompt treatment that may lead to a good prognosis. Neuroimaging will facilitate the diagnosis when other investigations show a borderline result.