Received Mar 19, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| TD | TD ADSORBED (NO BRAND NAME) | UNKNOWN MANUFACTURER | UNK | U8303A4 | SC / UN |
Bilateral Optic Neuritis following Td Vaccination no significant medical history or concomitant medications. No personal or family history of autoimmune disease. January 19, 2025: Received Td vaccine (Td Adult, absorbed, PMC, Lot U83003A4) from provider: Around 2 weeks later noted some pain around right temporal area at night which was worse when sleeping on his side and required sleeping on his back. February 19 noted blurred vision especially in lower visual field of right eye. Progressed to inability to make out any details with right eye and severe blurred vision of left eye over the following days with headache. February 24: Seen in the emergency room and bilateral optic nerve swelling was observed. Cerebral MRI with and without contrast showed findings consistent with bilateral optic neuritis but no vascular or parenchymal abnormalities. CSF and blood panels show elevation of myelin basic protein consistent with optic neuritis. Aquaporin-4 receptor antibody negative. Spine cervical MRI with and without contrast negative for white matter lesions. Spine thoracic MRI with and without contrast negative for white matter lesions. Admitted to the hospital overnight and discharged on February 25 Received 5 days of intravenous steroids from February 24 through March 1. Experienced headache and some neck pain intermittently. March 3: Visited neurologist. Evaluation negative for multiple sclerosis. Gradual improvement of vision but right eye continues impaired as of March 19, 2025.
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February 24 Brain MRI?Elevated T2 signal and enhancement within the orbital, canalicular, and portions of the prechiasmatic segments of the bilateral optic nerves. Findings are consistent with bilateral optic neuritis. Normal MR signal within the chiasmatic and post chiasmatic optic nerve segments.? 1. Findings consistent with bilateral optic neuritis as described above. Follow-up imaging is suggested. 2. No evidence of acute intracranial infarction or other acute intracranial abnormality. 3. No visualized intracranial white matter lesions or other areas of abnormal intracranial enhancement. February 24 Cervical and thoracic spine MRI without white matter lesions or other abnormalities. CSF without signs of infection. ANA HEp2 IFA elevated. Blood panel results available on request but without significant abnormalities.