Raised intracranial pressure with bilateral anterior uveitis

BMJ Case Rep. 2018 Jun 10:2018:bcr2017222504. doi: 10.1136/bcr-2017-222504.

Abstract

We report the rare case of a 5-year-old boy with an infective cause of papilloedema and bilateral uveitis secondary to Mycoplasma pneumoniae The patient presented with generalised headache and malaise. MRI showed signs of raised intracranial pressure and lumbar puncture opening pressure was 43 cmH2O.Lumbar puncture did not reveal any infective organisms. Blood tests showed raised inflammatory markers. The patient was started on prednisolone, acetazolamide and intravenous cefotaxime. Following an improvement, the patient was discharged.However, the patient re-presented 2 weeks later with bilateral anterior uveitis. With the combination of papilloedema and bilateral uveitis, M. pneumoniae infection was suspected. Tests confirmed recent mycoplasma infection. Topical dexamethasone and oral azithromycin were given and symptoms improved.Vision remained normal throughout. At 1-year follow-up, the patient remains well. The authors would like to highlight a rare infectious cause of papilloedema in young children.

Keywords: anterior chamber; coma and raised intracranial pressure; paediatrics.

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Diagnosis, Differential
  • Humans
  • Intracranial Pressure
  • Magnetic Resonance Imaging
  • Male
  • Mycoplasma pneumoniae* / drug effects
  • Mycoplasma pneumoniae* / isolation & purification
  • Optic Nerve / diagnostic imaging
  • Papilledema / complications
  • Papilledema / microbiology*
  • Uveitis, Anterior / complications
  • Uveitis, Anterior / microbiology*