The case – Starry Starry Sight – is shared by Charmaine Grace P. Malabanan, Southern Philippines Medical Center, Philippines.
Description: A 55-year-old female, previously admitted for typhoid fever, presented with a sudden onset, painless blurring of vision of the left eye. She was managed as a case of post-typhoid neuroretinitis. After treatment, visual acuity improved with resolution of disc edema.
Quiz
1. How is typhoid fever transmitted?
A. Contaminated food and water
B. Mosquito bite
C. Direct invasion
D. Air droplets
2. What laboratory work-up is the diagnostic method of choice for typhoid fever?
A. Bone marrow aspirate
B. Polymerase chain reaction
C. Blood culture
D. Widal test
3. Which typhoid-related ocular manifestations would you expect to see during the post-fever stage?
A. Optic nerve head edema
B. Neurosensory detachment
C. Focal or multifocal retinitis with macular star
D. All of the Above
4. Diagnosis of post-typhoid neuroretinitis is usually done through:
A. Laboratory work-up
B Clinical history and physical examination
C. Fluorescein angiography
D. Biopsy
5. Treatment of post-typhoid neuroretinitis is:
A. Piperacillin + Tazobactam
B. Steroids
C. Ceftriaxone
D. Carbonic anhydrase inhibitors
Answers:
1. A – Contaminated food and water
2. C – Blood culture
3. D – All of the Above
4. B – Clinical history and physical examination
5. B – Steroids