Short duration respiratory illness with abducens palsy in a young man.
Acute onset of diplopia associated with high-grade fever, sore throat and cough without features of raised intracranial tension in a young patient is an uncommon presentation. A diagnosis of abducent nerve palsy due to pontine tuberculoma associated with miliary tuberculosis was made based on sputum examination, chest x-ray and MRI. On diagnosis, monocular patching of the left eye was performed to avoid diplopia and primary antitubercular drugs with systemic steroids were given. An unfortunate 48 h delay in starting the antitubercular treatment likely decreased the probability of survival.
Department of Ophthalmology, Dr TMA Pai Rotary Hospital, Karkala, Manipal, Karnataka, India.
Vivekanand
V
Undrakonda
Shashikiran
S
Umakanth
D020434:Abducens Nerve Diseases / Q000382:microbiology*; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001927:Brain Diseases / Q000150:complications* / Q000175:diagnosis / Q000382:microbiology; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D013256:Steroids / Q000627:therapeutic use; D016862:Tuberculoma, Intracranial / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014391:Tuberculosis, Miliary / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy*; D055815:Young Adult
D000995:Antitubercular Agents; D013256:Steroids