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Journal of Pediatric Neurology 2022; 20(02): 148-151
DOI: 10.1055/s-0041-1741071
Case Report

Bilateral Optic Neuritis Caused by Meningococcal Meningoencephalitis

Herta Zellner
1   Department of Pediatrics, Innsbruck Medical University, Innsbruck, Austria
,
Andreas Entenmann
1   Department of Pediatrics, Innsbruck Medical University, Innsbruck, Austria
,
Iris Unterberger
2   Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
,
Armin Muigg
2   Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
,
Stephan Egger
3   Department of Pediatrics, Bruneck Hospital, Italy
,
Miriam Kössler
1   Department of Pediatrics, Innsbruck Medical University, Innsbruck, Austria
,
Fiona Zeiner
1   Department of Pediatrics, Innsbruck Medical University, Innsbruck, Austria
,
Matthias Baumann
1   Department of Pediatrics, Innsbruck Medical University, Innsbruck, Austria
,
Barbara Teuchner
4   Department of Ophthalmology, Innsbruck Medical University, Innsbruck, Austria
,
Tanja Janjic
5   Department of Neuroradiology, Innsbruck Medical University, Innsbruck, Austria
,
Diana Putz
4   Department of Ophthalmology, Innsbruck Medical University, Innsbruck, Austria
,
Manuela Zlamy 
1   Department of Pediatrics, Innsbruck Medical University, Innsbruck, Austria
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Abstract

In this article, we described a case of pathogen-induced bilateral optic neuritis accompanying meningococcal meningoencephalitis in an adolescent male. A 15-year-old boy presented to our emergency room due to progressive severe headache, stiff neck, diffuse extremity pain, fever, and nausea concerning meningoencephalitis. Intravenous ceftriaxone, metamizole, and ondansetron were started immediately. Due to acute autonomic dysregulation and development of petechiae, he was transferred to the pediatric intensive care unit. Next morning, the patient developed severe visual impairment. Investigations revealed elevated C-reactive protein, procalcitonin and leucocyte count, decreased platelet count, and clotting activation. Cerebrospinal fluid (CSF) analysis revealed increased leucocyte count, protein, and decreased glucose concentration with pathological CSF cytology. Brain magnetic resonance imaging revealed an increased contrast enhancement in the optic nerve sheath, consistent with acute bilateral optic neuritis. He was started on high-dose intravenous pulse methylprednisolone therapy. After treatment with ceftriaxone und pulse steroids, the patient was discharged in good condition without any visual sequel.

Keywords

meningococci - optic neuritis - meningoencephalitis


Publication History

Received: 08 August 2021

Accepted: 22 November 2021

Article published online:
07 January 2022

© 2022. Thieme. All rights reserved.

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