Case Blog - (2016) Volume 4, Issue 4
Saidatul Akma Sharif, Mohanarasan Ratanam* and Nurliyana Ain Abdul Ghani
Ophthalmology Department, Sultan Haji Ahmad Shah Hospital, Temerloh, Pahang, Malaysia
*Corresponding Author:
Mohanarasan Ratanam
Ophthalmology Department
Sultan Haji Ahmad Shah Hospital
Temerloh, Pahang, Malaysia
Tel: 60 9-295 5333
E-mail: mohanslayer@gmail.com
Received Date: 07 October 2016; Accepted Date: 10 October 2016; Published Date: 14 October 2016
Case Blog
Citation: Sharif SA, Ratanam M, Abdul Ghani NA. The Gold Miners Neuroretinitis. Ann Clin Lab Res. 2016, 4: 4 doi: 10.21767/2386-5180.1000129
A 21 years old traditional gold miner presented with fever and subsequently seizures for a week duration. Clinical examinations and lab investigations led to a diagnosis of Leptospiral Meningitis and the gentleman was treated with intravenous Amoxy-Clavulinic Acid. During the course of treatment, the gentleman noticed progressive blurring of vision of the left eye.
Objective
To describe the potential hazards to traditional gold miners without personal protective equipment in the gold mines of Raub district, Pahang, Malaysia.
Case Summary
A 21 years old traditional gold miner presented with fever and subsequently seizures for a week duration. Clinical examinations and lab investigations led to a diagnosis of Leptospiral Meningitis and the gentleman was treated with intravenous Amoxy-Clavulinic Acid. During the course of treatment, the gentleman noticed progressive blurring of vision of the left eye.
Visual acuity when first examined was 6/60 with fundus examination showing gross optic disc swelling with extensive choroiditis forming a perfect radius surrounding the optic disc. A diagnosis of neuroretinitis secondary to Leptospirosis was made and oral Doxycycline was given. Once the infection was under control oral Prednisolone was started to keep retinal inflammation at bay (Figure 1 and Figure 2).
Figure 1: Fundus photograph of the left eye showing gross optic disc swelling and extensive choroiditis in a radius around the optic disc.
Figure 2: Fundus photography of the left eye of the same patient in the early venous phase of fluorescein angiography. There are numerous choroiditic lesions seen as subretinal blots in this photograph. The retinal vessels appears intact with no signs of leakages.
Conclusion
Traditional gold mining remains an important source of income in some parts of the world such as in the Raub district of Pahang, Malaysia. These miners are exposed to infectious diseases such as Leptospirosis in this case due to the lack of awareness in using proper personal protective equipments.
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