Work

Bilateral Optic Neuritis as the Initial Presentation of Acute HIV Infection in a Young Bodybuilder: A Case Report

Year: 2026

Type: article

Abstract: Background and Clinical Significance: Optic neuritis, an inflammatory demyelinating condition affecting the optic nerve, can present as an isolated phenomenon or as a harbinger of an underlying systemic disorder. While often associated with multiple sclerosis (MS), optic neuritis has been reported in the context of various infectious and inflammatory conditions, including human immunodeficiency virus (HIV) infection. Case Presentation: We describe a case of bilateral optic neuritis that led to the diagnosis of acute HIV infection in a young man actively engaged in bodybuilding, anabolic steroid use, and high-risk sexual behavior. The patient initially presented with an acute onset of vision loss, headache, and photophobia. Magnetic resonance imaging (MRI) findings confirmed demyelination of the optic nerves, and laboratory workup revealed acute HIV-1 infection. The patient improved following high-dose corticosteroids and initiation of antiretroviral therapy. Conclusions: This case highlights the need to consider systemic infections such as HIV in atypical presentations of optic neuritis.

Source: Reports — Medical Cases Images and Videos

DOI: 10.3390/reports9010052

Authors: Jennifer Lu, Kathleen Tor, Joseph Yasmeh, Monique George

Institution: Kaiser Permanente

Language: English

Topic: HIV Research and Treatment

Subfield: Virology

Field: Immunology and Microbiology

Domain: Life Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,689