Blindness as a presenting feature of leptospiral infection: A case report and review of literature

Abstract

Leptospira is an emerging cause of acute febrile illness in India, which is acquired through contact of skin with contaminated water and soil. Generally, leptospirosis has mild, self-limiting course; rarely, multiple organ dysfunction can occur like aseptic meningitis (20%) and Weil’s disease (10%). Here, we report a case of bilateral optic neuritis in a girl child who presented with blindness following Leptospira infection. On ophthalmological examination, she could appreciate hand movements close to face and had afferent pupillary defect bilaterally. Fundoscopy showed normal fundus with no signs of disc edema. Magnetic resonance imaging (MRI) of brain and orbit showed bilateral hyperintensities in the optic nerve. Visual evoked potential showed prolonged latency in p100 wave in both eyes, suggestive of bilateral optic neuritis. She was diagnosed with Leptospira infection with aseptic meningitis and retrobulbar optic neuritis. She was treated conservatively. She responded well with improvement of visual acuity to 6/6 at the time of discharge.