Open AccessOptic neuritis caused by the re-emerging great masquerader
Author(s) -
Nathanial S Nolan,
Laura E. Gibbons,
Madihah Hepburn,
Ahmed Elkeeb,
Hariharan Regunath
Publication year - 2018
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2018-225635
Subject(s) - medicine , photophobia , optic neuritis , rapid plasma reagin , lumbar puncture , blurred vision , syphilis , rash , dermatology , blind spot , surgery , cerebrospinal fluid , multiple sclerosis , ophthalmology , treponema , human immunodeficiency virus (hiv) , pathology , psychiatry , immunology , artificial intelligence , computer science
A 49-year-old Caucasian woman presented with subacute headache and right eye pain associated with scotoma, blurred vision and photophobia. MRI was suggestive of optic neuritis of the right optic nerve and she was treated with steroids. Due to persistent symptoms, a lumbar puncture was performed and cerebrospinal fluid analysis was positive for venereal disease research laboratory and rapid plasma reagin titres. On further history, she recalled experiencing an illness associated with diffuse rash, likely secondary syphilis, 1-2 months prior. She tested negative for HIV. She was treated with intravenous penicillin for 2 weeks following which she experienced improvement in symptoms.