Favorable visual outcome in cryptococcal meningitis.
OBJECTIVE
To describe an unusual, favorable visual outcome in a patient with lupus erythematosus and cryptococcal meningitis and to present bilateral superior oblique muscle paresis.


METHODS
Case report. A 15-year-old girl with lupus erythematosus and cryptococcal meningitis had bilateral superior oblique paresis, bilateral optic nerve head swelling, and increased intracranial pressure. She developed a visual acuity of no light perception in the right eye.


RESULTS
Treatment with oral fluconazole, acetazolamide, and dexamethasone, as well as repeated lumbar punctures to reduce intracranial pressure, was followed by recovery to a visual acuity of 20/20 in both eyes and normal ocular motility.


CONCLUSIONS
With appropriate treatment, visual loss associated with cryptococcal meningitis may have a favorable outcome.
Ferreira
R C
RC
Department of Ophthalmology, Children's Hospital, University of Colorado, Denver, USA.
Phan
G
G
Bateman
J B
JB
D000086:Acetazolamide / Q000627:therapeutic use; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications / Q000601:surgery; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000188:drug therapy; D016919:Meningitis, Cryptococcal / Q000150:complications* / Q000188:drug therapy; D009886:Ophthalmoplegia / Q000150:complications / Q000188:drug therapy; D009902:Optic Neuritis / Q000150:complications; D013129:Spinal Puncture; D014786:Vision Disorders / Q000209:etiology* / Q000503:physiopathology; D014792:Visual Acuity
D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D003907:Dexamethasone; D015725:Fluconazole; D000086:Acetazolamide