[Mycotic retrobulbar neuritis]

Klin Monbl Augenheilkd. 1994 Apr;204(4):244-7. doi: 10.1055/s-2008-1035526.
[Article in German]

Abstract

Background: Fungal disease is one of the most common complications of malignant haematologic disease. In the major part of the patients the lungs and the gastrointestinal tract are affected. Infections of the eyes and adnexa are very rare.

Patient and methods: A 75-year-old woman presented with acute unilateral loss of vision. The history revealed an anaplastic anemia. Vision of the affected eye decreased to light perception. The ophthalmoscopic findings were normal. A retrobulbar tumor was diagnosed by ultrasonography and CT. It was regarded as a glioma or a meningioma. A Non-Hodgkin lymphoma of low malignancy was proven by biopsy of bone marrow; hence a retrobulbar lymphoma was included in the differential diagnosis. Radiation was started, but the general state of health worsened and the patient died. AUTOPSY FINDINGS: A severe mycotic infiltration of the left optic nerve sheath was found, which had broadened the spatium intervaginale. Cause of death was a pneumonia by generalized immunocytoma.

Conclusions: In cases with retrobulbar tumors and malignant haematologic diseases fungal infections should be included in the differential diagnosis. Serologic investigations are useful. The prognosis is poor and depends on the course of the basic disease.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged
  • Anemia, Aplastic / complications
  • Anemia, Aplastic / drug therapy
  • Diagnosis, Differential
  • Female
  • Humans
  • Lymphoma, Non-Hodgkin / complications
  • Lymphoma, Non-Hodgkin / drug therapy
  • Opportunistic Infections / diagnosis*
  • Opportunistic Infections / pathology
  • Optic Nerve / pathology
  • Optic Neuritis / diagnosis*
  • Optic Neuritis / pathology
  • Orbital Neoplasms / diagnosis
  • Orbital Neoplasms / pathology
  • Prednisolone / administration & dosage
  • Prednisolone / adverse effects
  • Tomography, X-Ray Computed

Substances

  • Prednisolone