Título / Title

ATYPICAL SPOROTHRIX NEURORETINITIS

Introdução / Purpose

Neuroretinitis is a rare inflammatory optic neuropathy characterized by acute unilateral painless vision loss, optic disc swelling and subsequent formation of macular stars. Neuroretinitis etiology ranges from ocular to systemic diseases. Our case is about a patient with typical neuroretinitis examination evaluated with multimodal retinal exams and with extensive etiology investigation.

Material e Método / Methods

Case Report

Resultados / Results

A previously healthy 36-year-old woman presented to the emergency department with chief complaint of subacute onset of blurry vision in right eye (OD) for the last four days. At the ophthalmologic exam, she presented with best corrected visual acuity (BCVA) of 0,1 (LogMAR) in OD and 0,0 in the left eye (OS); There was a right relative afferent pupillary defect. At anterior biomicroscopy exam was unremarkable. At the retinal fundoscopic exam of the right eye revealed optic disc swelling and retinal thickening extending to the macula; the vitreous fluid was clear, the vessels appeared normal, and retina was flat with no breaks, bleeds, or detachments. Her left eye fundus was unremarkable. Her physical examination, including her neurologic examination, was overall unremarkable. Lab results were unremarkable, as well MRI of skull and orbit, oular ultrasound, lumbar punction and serologies, including Bartonella henselae. In the follow-up, the serology for Bartonella was negative for the second time and the PPD test result was 13mm. The patient reported improvement of visual acuity and at the colour fundus retinography showed the partial resolution of the macular star and significant improvement of the intraretinal edema and retinal detachment were observed in the SS-OCT. At that time, a polymerase chain reaction (PCR) test was requested for sporotrichosis. The PCR results came back positive for Sporothrix brasiliensis and Sporothrix schenckii.

Discussão e Conclusões / Conclusion

This is the first case report of an NR related tô Sporothrix with PCR positive analysis.

Palavras Chave

neurorretinitis
bartonella
sporothrix