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Blinded by Zika? A missed HIV diagnosis that resulted in optic neuropathy and blindness: a case report

Overview of attention for article published in BMC Research Notes, December 2017
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  • Above-average Attention Score compared to outputs of the same age (52nd percentile)
  • Above-average Attention Score compared to outputs of the same age and source (64th percentile)

Mentioned by

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5 tweeters

Citations

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2 Dimensions

Readers on

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27 Mendeley
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Title
Blinded by Zika? A missed HIV diagnosis that resulted in optic neuropathy and blindness: a case report
Published in
BMC Research Notes, December 2017
DOI 10.1186/s13104-017-2970-5
Pubmed ID
Authors

Tiffany Hirschel, Heimo Steffen, Victor Pecoul, Alexandra Calmy

Abstract

Typical symptoms of an acute human immunodeficiency virus (HIV) infections like fever and rash are not specific and can be caused by a multitude of other pathogens, such as Zika or rickettsiosis. Up to 30% of primary HIV infection do not present with the typical flu-like symptoms and thus represent a diagnostic challenge. In this report, we describe a rare case of optic neuropathy as the initial presentation of primary HIV infection, which resulted in irreversible blindness. To our knowledge, only four cases of optic neuropathy resulting from a recent HIV seroconversion have been reported. In January 2015, a 72-year-old man presented with a rash, fever and diffuse myalgias after returning from a fortnight in Cuba. In the context of the current polemic, Zika was considered likely. A diagnostic work-up, including dengue fever and Zika, was negative. Symptoms resolved spontaneously. In March, the patient experienced a sudden loss of vision first on one, a few days later on the other eye. Magnetic resonance imaging showed optic nerve enhancement suggesting neuritis. Numerous infective causes were sought and the patient was diagnosed with HIV. Corticosteroids and antiretroviral therapy were initiated but vision did not improve. Four weeks later an optic atrophy developed. After more than a year of follow-up the patient remains blind. Stored serum from January revealed a detectable viremia with a negative Western blot assay, typical of acute HIV infection. Optic neuritis is a rare complication of early HIV infection. Only four others cases have been described, some of which recovered their vision after the administration of corticosteroids and/or ARV treatment. The balance between ischemic and neuroimmune processes may play a role in recovery. Delayed diagnosis, due to an unjustified focus on the Zika virus may have contributed to the tragic outcome.

Twitter Demographics

The data shown below were collected from the profiles of 5 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 27 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 5 19%
Student > Master 5 19%
Student > Ph. D. Student 3 11%
Professor 3 11%
Librarian 2 7%
Other 4 15%
Unknown 5 19%
Readers by discipline Count As %
Medicine and Dentistry 9 33%
Mathematics 2 7%
Arts and Humanities 2 7%
Nursing and Health Professions 2 7%
Social Sciences 2 7%
Other 5 19%
Unknown 5 19%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 August 2018.
All research outputs
#7,508,096
of 13,333,056 outputs
Outputs from BMC Research Notes
#1,192
of 3,015 outputs
Outputs of similar age
#177,411
of 387,690 outputs
Outputs of similar age from BMC Research Notes
#129
of 407 outputs
Altmetric has tracked 13,333,056 research outputs across all sources so far. This one is in the 42nd percentile – i.e., 42% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,015 research outputs from this source. They receive a mean Attention Score of 4.4. This one has gotten more attention than average, scoring higher than 58% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 387,690 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 52% of its contemporaries.
We're also able to compare this research output to 407 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 64% of its contemporaries.