An Atypical Case of Enterovirus Meningitis Presenting with Unilateral Optic Disc Swelling and Minimal Optical Symptoms

ABSTRACT

Purpose

To report a case of unilateral disc swelling as the only presentation of enterovirus meningitis in a 43-year-old male who presented with reduction in visual quality.

Methods

Vision was 20/20 unaided in both eyes and the only ocular finding was left optic disc edema accompanied by left relative afferent pupillary defect. Visual field examination revealed a generalized reduction in sensitivity, a paracentral scotoma and a superior and inferior arcuate defect. Apart from a marginally elevated white blood cell count, the evaluation for common diseases associated with unilateral disc swelling was negative. A comprehensive neurology and rheumatology assessment,the orbital, brain and cervical spine Magnetic Resonance Imaging (MRI), the chest and abdomen Computed Tomography (CT) and chest radiograph had no findings. However, the cerebrosipinal fluid (CSF) examination indicated the presence of enterovirus RNA.

Results

A diagnosis of enterovirus meningitis was established.Patient’s general health was not affected and symptoms gradually settled, with no specific anti-enteroviral treatment.

Conclusion

Only the CSF analysis provided interesting evidence of the site of the visual dysfunction.

ΚEYWORDS:

• Optic disc swelling
• Enterovirus
• Μeningitis
• Visual impairment
• Visual field defects

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data are available by the corresponding author (E.C) upon request.

Animal research

The article does not contain any studies with animals.

Consent to publish

All authors have signed a consent form for the publication of the article.

Ethical approval

The study was conducted according to the tenets of the Declaration of Helsinki and the Ethics Committee of the Hospital involved.

Informed consent

Informed consent for the treatment protocol and the data collection was obtained from the patient.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.