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Case Reports
. 2019 Jul 11:18:e00579.
doi: 10.1016/j.idcr.2019.e00579. eCollection 2019.

Bilateral primary optic neuropathy as the presenting manifestation of tuberculosis in an immunocompetent patient

Santhosh Narayanan  1 , Divya Prakash  2 , Gomathy Subramaniam  3
Affiliations
Case Reports

Bilateral primary optic neuropathy as the presenting manifestation of tuberculosis in an immunocompetent patient

Santhosh Narayanan et al. IDCases. .

Abstract

Vision impairment is one of the devastating complications of central nervous system tuberculosis (CNS TB). Optic atrophy is a sequelae of various forms of CNS TB which, ultimately, is responsible for vision impairment. It is usually the secondary optic atrophy which occurs in CNS TB. In this case report, we present the story of an immunocompetent woman presenting as bilateral visual loss. She was found to have primary optic atrophy. Neuroimaging revealed features of chronic meningitis. Polymerase chain reaction test for Mycobacterium tuberculosis was positive in cerebrospinal fluid. Although secondary optic atrophy is common in the CNS TB, as a complication of meningitis, primary optic atrophy per se is infrequently reported.

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Figures

Fig. 1
Fig. 1
Relative afferent papillary defect.
Figs. 2 and 3
Figs. 2 and 3
Chalky white optic disc suggestive of primary optic atrophy.
Fig. 4
Fig. 4
MRI showing pachy, leptomeningitis and thinned out optic nerve.
See this image and copyright information in PMC

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