[Optic neuritis after a bee sting].
Optic neuritis is an acute inflammation of the optic nerve and, in its atypical form, is caused by inflammation of the optic nerve as part of infectious, immune, granulomatous, or contiguity processes. Hymenoptera stings (bees, wasps and ants) have been associated with different clinical presentations, ranging from local events to systemic manifestations, such as anaphylaxis, glomerulonephritis and central nervous system involvement (ischemic vascular lesions, optic neuritis and demyelinating lesions). This is a report of the case of a 62-year-old woman that after three days of being stung by a bee in the left lower eyelid, showed decreased visual acuity of both eyes and central scotoma, concomitant bilateral headache and eye pain, exacerbated by eye movements. The ophthalmological examination showed that visual acuity was decreased and the bilateral fundus examination revealed blurred optic disks edges. Hyperintense thickening of the left optic nerve was observed with an ocular MRI. Due to the clinical manifestations and epidemiological history, the diagnosis of bilateral optic neuritis was established. Treatment with pulses of 1 g/daily of methylprednisolone was initiated, for three days, with clinical improvement within 24 hours after receiving the first dose. Since 1960, cases of optic neuritis associated with hymenoptera stings have been documented, which take the form of anterior optic neuritis. A case of a patient who presented clinical features of bilateral optic neuritis after been stung by a bee, with a good clinical outcome after treatment with methylprednisolone is reported.
Servicio de Medicina Interna, Hospital Dr. Héctor Nouel Joubert, IVSS. rosannamedicina@hotmail.com
Rosanna de Carmen
Rde C
Zambrano-Infantino
Jean Félix
JF
Piñieríia-Gonsálvez
César
C
Montaño
Carlos
C
Rodríguez
D000208:Acute Disease; D000382:Agricultural Workers' Diseases; D000818:Animals; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001516:Bees; D058447:Eye Pain / Q000209:etiology; D005143:Eyelids / Q000293:injuries; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D009902:Optic Neuritis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D012607:Scotoma / Q000209:etiology; D014792:Visual Acuity
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone