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JAMA Ophthalmology Clinical Challenge
October 2018

Optic Nerve Swelling in a Patient With Cancer

Author Affiliations
  • 1Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
  • 2Department of Ophthalmology, Bascom Palmer Eye Institute, Miami, Florida
  • 3Retina Consultants, PC, Hartford, Connecticut
JAMA Ophthalmol. 2018;136(10):1195-1196. doi:10.1001/jamaophthalmol.2018.0163

A woman in her 60s with diffuse large B-cell lymphoma was admitted for fevers, sepsis, and Enterococcus faecalis urinary tract infection in the context of bilateral malignant ureteral obstruction. Physical examination was notable for a genital vesicular rash; a culture of the skin lesion yielded herpes simplex virus (HSV). Blood cultures were positive for Candida glabrata, triggering an ophthalmology consultation to rule out ocular candidiasis. The patient reported blurry vision in both eyes for 1 week.

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