Bilateral optic nerve infiltration in tuberculous meningitis: A diagnostic dilemma  

作　　者：Lim Thiam-Hou Ibrahim Mohtar Wan Hazabbah Wan Hitam Sanihah Abdul Halim 

机构地区：[1]Department of Ophthalmology and Visual Science,School of Medical Sciences,Health Campus,Universiti Sains Malaysia,16150 Kubang Kerian,Kelantan,Malaysia [2]Hospital Universiti Sains Malaysia,16150 Kubang Kerian,Kelantan,Malaysia [3]Department of Medicine,School of Medical Sciences,Health Campus,Universiti Sains Malaysia,16150 Kubang Kerian,Kelantan,Malaysia

出　　处：《Journal of Acute Disease》2021年第2期87-90,共4页急性病杂志（英文版）

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.

关 键 词：Tuberculous meningitis Infiltrative optic neuropathy TUBERCULOMA 

分 类 号：U45[建筑科学—桥梁与隧道工程]