雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

A case of aseptic meningitis with acute esotropia as the chief complaint Naoyuki Serita 1 , Xue Tan 1 , Takahiro Suzuki 1 , Yasuyuki Suzuki 1 1Department of Ophthalmology, Tokai University Hospital pp.702-708
Published Date 2024/6/15
DOI https://doi.org/10.11477/mf.1410215194
  • Abstract
  • Look Inside
  • Reference

Abstract Purpose:We report a case of meningitis wherein the patient's chief complaint was acute esotropia.

Case:A 14-year-old girl presented to a local neurosurgery clinic with a headache and nausea. Brain MRI scan showed no cerebral abnormalities, and the patient was kept under observation. Ten days later, she developed diplopia and was referred to our department due to acute-onset esotropia. The best-corrected visual acuity was 0.8 in the right eye and 1.2 in the left eye;esotropia and abduction disorder of the left eye were observed. Although the critical flicker frequency was normal, papilledema was observed in both eyes. Goldmann visual field examination revealed enlargement of the left Mariotte's blind spot, and MRI showed mild edematous changes around the optic nerves. Meanwhile, cerebrospinal fluid(CSF)examination revealed meningitis with elevated CSF pressure, increased lymphocyte-predominant cell counts and elevated protein levels, but no bacteria were detected. Since papilledema and signs of meningeal irritation suggested the possibility of neuromyelitis optica, the patient received pulse therapy with subsequent oral prednisolone therapy.

 After treatment, CSF abnormalities subsided and visual acuity improved to 1.2 in both eyes. Both left eye abduction disorder and bilateral papilledema were improved. Since the patient was negative for anti-aquaporin 4 and anti-MOG antibodies, no abnormal findings were observed on spinal MRI. Further, the presence of cytomegalovirus(CMV)antibodies was revealed in the blood test. We considered that patient's symptoms might be due to aseptic meningitis caused by CMV.

Conclusion:We reported a case of aseptic meningitis presenting with acute esotropia and papilledema. For cases with abnormal ocular movement and symptoms of meningeal irritation, CSF examination is an important diagnostic tool.


Copyright © 2024, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

関連文献

もっと見る

文献を共有