Rapid Reversal of Complete Binocular Blindness With High-Dose Corticosteroids and Lumbar Drain in a Solid Organ Transplant Recipient With Cryptococcal Meningitis and Immune Reconstitution Syndrome: First Case Study and Literature Review

Zoe Weiss; Nihaal Mehta; Su Nandar Aung; Michael Migliori; Dimitrios Farmakiotis

doi:10.1093/ofid/ofy007

Rapid Reversal of Complete Binocular Blindness With High-Dose Corticosteroids and Lumbar Drain in a Solid Organ Transplant Recipient With Cryptococcal Meningitis and Immune Reconstitution Syndrome: First Case Study and Literature Review

Open Forum Infect Dis. 2018 Jan 8;5(2):ofy007. doi: 10.1093/ofid/ofy007. eCollection 2018 Feb.

Authors

Zoe Weiss¹, Nihaal Mehta², Su Nandar Aung³, Michael Migliori⁴, Dimitrios Farmakiotis⁵

Affiliations

¹ Department of Internal Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
² Warren AlpertMedical School of Brown University, Providence, Rhode Island.
³ Division of Infectious Disease, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
⁴ Division of Ophthalmology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
⁵ Division of Infectious Disease, Rhode Island Hospital, Warren Alpert Medical School of Brown University, Providence, Rhode Isl.

Abstract

Blindness is a rare, devastating, usually permanent complication of cryptococcal meningitis (CM). We present the first case of complete vision loss in a solid organ transplant recipient with CM treated with placement of a lumbar drain who had a dramatic visual recovery that started after 3 doses of high-dose steroids.

Keywords: CM-IRIS; cryptococcal meningitis; immune reconstitution inflammatory syndrome; vision loss.