Cases Of Pachymeningitis Research Articles

Toxoplasmic pachymeningitis with visual field impairment in a single-eyed patient and a literature review

To describe the clinical features of a patient with toxoplasmic pachymeningitis and provide a review of the recent cases of pachymeningitis in the literature.Retrospective, observational case report. A one-eyed patient who presented to our institution with blurred vision, floaters, and visual field shrinkage. Review of clinical, laboratory, perimetric, and radiologic records of the patient and description of the efficacy of antibiotic therapy. The signs of ocular impairment, including visual acuity, visual field, and magnetic resonance imaging (MRI) changes. A one-eyed patient who complained of blurred vision and unexplained visual field shrinkage was evaluated. The diagnosis of toxoplasmic pachymeningitis was confirmed by existence of a toxoplasmic seroconversion, cerebrospinal fluid abnormalities, radiological features, absence of other diagnoses, improvement of symptoms, and resolution of pachymeningitis in MRI with oral trimethoprim–sulfamethoxazole combination.Pachymeningitis is a rare disease and toxoplasmic pachymeningitis has never been described. Among the various infectious causes, screening for toxoplasmosis must be performed because it can lead to pachymeningitis and sequelae. Variable features may lead to misdiagnosis and delay in the treatment of this sight-threatening and potentially fatal disease.

Three Cases: One with the Usual Symptoms of General Paralysis, One with Doubtful Symptoms, and the Third with Marked Symptoms; Pachymeningitis in all. [With illustration.

The three Cases following are not so very rare, but are still of interest from several points of view. In Bethlem we have yearly ten or twelve post-mortems on more or less acute cases of general paralysis, and in general hospitals cases similar in the main, with but little mental perversion, but with weakness of mind are common, yet it is rare for the general pathologist to come across cases of pachymeningitis. This condition, if not solely found in general paralysis, is by far more common in this than in any other disease of the brain. In Bethlem, out of over 100 cases of examination after death, these are the only three well-marked examples of this condition of the membranes we have met with. In one other there were slight effusions occurring with fits, but these after death were found only as very thin discoloured layers, three in number, together not being above one-eighth of an inch in thickness. In the first case, the membrane was complete, and resembled a dark, sodden dura-mater, and was very complete over the whole sides and vertex of the brain. It was absent from the base, though here there was a staining at the edge of the membrane.