Presumed ocular toxoplasmosis presenting as papillitis.
Unilateral papillitis is a rare manifestation of ocular toxoplasmosis. However, other causes of papillitis need to be ruled out before concluding the diagnosis.
Biomedical subjects
Publications and source records attributed to Radha Shenoy.
Unilateral papillitis is a rare manifestation of ocular toxoplasmosis. However, other causes of papillitis need to be ruled out before concluding the diagnosis.
PURPOSE: To report that acute phenytoin toxicity may result in acute visual dysfunction. METHODS: A 19-year old man with cryptogenic simple partial and secondary generalized epilepsy developed blurred vision and xanthopsia after phenytoin loading for status epilepticus. Color blindness was found on testing with Ishihara's pseudo-isochromatic charts and visual fields (Goldmann perimeter) showed gross concentric constriction in both eyes. Flash visually evoked potentials showed prolonged P1 latency in both the eyes. Serum free-phenytoin concentration revealed toxic levels of phenytoin and no other etiology for retinopathy or optic neuropathy. RESULTS: Phenytoin was withheld and the patient experienced a partial recovery in conjunction with reduced serum levels of phenytoin. Ten months later flash visually evoked potentials were normal but electroretinogram confirmed diffuse bilateral cone and rod dysfunction. CONCLUSION: Phenytoin toxicity may result in acute visual dysfunction a previously unreported phenomenon.
In the early stages of Wegener's granulomatosis, and in the atypical forms, the classic clinicopathologic features of the disease are often absent, delaying diagnosis. Recognition of the disease and its variant is aided by serological markers.