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Favorable visual outcome in cryptococcal meningitis
R C Ferreira1, G Phan, J B Bateman
1Department of Ophthalmology, Children's Hospital, University of Colorado, Denver, USA.
American Journal of Ophthalmology
|November 5, 1997
Summary
A lupus patient with cryptococcal meningitis experienced severe vision loss but regained 20/20 vision with appropriate treatment. This case highlights favorable visual outcomes in fungal meningitis.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Neurology
Background:
- Systemic lupus erythematosus (SLE) can predispose individuals to opportunistic infections.
- Cryptococcal meningitis is a serious fungal infection affecting the central nervous system.
Observation:
- A 15-year-old female with SLE presented with cryptococcal meningitis.
- The patient exhibited bilateral superior oblique muscle paresis, optic nerve head swelling, and elevated intracranial pressure.
- Initial visual acuity in the right eye was no light perception.
Findings:
- Treatment involved fluconazole, acetazolamide, and dexamethasone, alongside therapeutic lumbar punctures.
- The patient achieved complete visual recovery to 20/20 in both eyes.
- Normal ocular motility was restored.
Implications:
- Aggressive management of increased intracranial pressure and fungal infection is crucial.
- Favorable visual outcomes are possible even in severe cases of cryptococcal meningitis.
- This case underscores the importance of prompt and comprehensive treatment for CNS fungal infections in immunocompromised patients.