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Severe optic neuritis in infectious mononucleosis.

J Jones1, W Gardner, T Newman

  • 1Department of Emergency Medicine and Infectious Disease, Northeastern Ohio Universities, College of Medicine, Akron 44307.

Annals of Emergency Medicine
|April 1, 1988
PubMed
Summary

Infectious mononucleosis can present unusually in older adults, sometimes causing severe optic neuritis and vision loss. This case highlights the importance of considering Epstein-Barr virus in elderly patients with unexplained visual impairment.

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Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Neurology

Background:

  • Infectious mononucleosis, typically caused by Epstein-Barr virus (EBV), often presents with fever, pharyngitis, and lymphadenopathy.
  • Atypical presentations in the elderly can lead to delayed or missed diagnoses.
  • Ocular complications, though rare, can occur and significantly impact visual function.

Observation:

  • A 61-year-old male presented with severe visual impairment as his primary symptom.
  • Optic neuritis was the sole prominent clinical finding, with serologic testing confirming Epstein-Barr virus infection.
  • Despite near-complete visual recovery, persistent optic atrophy was noted.

Findings:

  • This case represents an unusual presentation of infectious mononucleosis in an elderly individual.

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  • Optic neuritis associated with EBV infection can lead to significant visual deficits.
  • Literature review identified seven additional documented cases of optic neuritis linked to infectious mononucleosis.

    • Implications:

    • Clinicians should consider infectious mononucleosis in elderly patients presenting with unexplained visual disturbances, particularly optic neuritis.
    • Early diagnosis and management of EBV-associated optic neuritis may improve visual outcomes.
    • Further research into the pathogenesis of parainfectious optic neuritis is warranted to understand and potentially prevent this complication.