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Leber's idiopathic stellate neuroretinitis: differential diagnosis and approach to management.

BACKGROUND: Leber's idiopathic stellate neuroretinitis (LISN) is a relatively uncommon clinical entity that is characterized by optic disc oedema and associated macular hard exudates. A broad range of causes can produce such a fundus appearance. METHODS: The clinical experience of the authors is combined with a review of the pertinent literature to describe the features of LISN and its differential diagnosis. CONCLUSION: A knowledge of the potential causes of neuroretinitis is important in order to formulate an effective management strategy.

Cat-Scratch Disease↗

Late onset of serologic positive titers in a patient with Parinaud's oculoglandular syndrome.

PURPOSE: To report a case of Parinaud's oculoglandular syndrome (POS) in which, despite the initially negative, a late onset of serologic positive titers was observed. METHODS: Case report. RESULTS: A 65-year-old man was examined for a foreign body in the left eye associated with granulomatous nodule on the palpebral conjuctiva, chemosis and a swollen preauricular lymph node. Despite the initially negative serologic titers to Bartonella henselae, a clinical diagnosis of POS was made and treatment was instituted initially with oral ciprofloxacin (500 mg twice a day). Three weeks later, serologic positive titers were found which confirmed the diagnosis of POS. CONCLUSION: Even though the improvements in diagnostic testing such as indirect immunofluorescence antibody, negative titles could be initially observed, confusing the diagnostic process. Other techniques (such as polymerase chain reaction (PCR) testing) should be also taken into consideration in cases with increased clinical suspicious of B. henselae indections.

Aged↗

A man with fever and lymphadenopathy.

A 40-year-old man presented with a three-week history of malaise, nausea, night sweats, decreased appetite, and a 15-lb weight loss. He reported having had diarrhea, occasionally with bright red blood, for the first two weeks and a temperature as high as 39.4 degrees C for the last two weeks. He had not had cough, shortness of breath, wheezing, chest pain, arthralgias, rash, or conjunctivitis. He had not eaten raw oysters or raspberries.

Adult↗