An Unusual Case of Pyrexia with Blindness

Abstract

Pyrexia is a common clinical problem; causes may vary depending on the clinico- epidemiological settings. Infectious diseases form the most common cause of fever especially in the immunocompromised category. The cause may not be obvious from the initial presentation and a stepwise workup is usually required. Potential diagnostic clues are very important in this regard. Our patient had a fever for 2 months and blindness for 1 month. The etiology of pyrexia with blindness can be linked to ophthalmic infections like viral, bacterial, parasitic, and fungal retinitis or micro vasculopathy (disease of small vessels) of retinal vessels or central nervous system causes like stroke, tuberculosis, toxoplasmosis, syphilis, and John Cunningham Virus infection. We report a case of a 60-year-old female who presented with complaints of fever, productive cough, burning micturition, and loss of vision. A stepwise workup was done in search of the causes of pyrexia with blindness. The serum was negative for toxoplasma and cytomegalovirus antibodies, the Venereal disease research laboratory test was negative, and the cerebral fluid CBNAAT for tuberculosis was negative. After the extensive workup, the patient was found reactive to Human Immunodeficiency Virus – 1 antibody, and her CD4 count was 66 only.