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Learning from errors
Short duration respiratory illness with abducens palsy in a young man
  1. Vivekanand Undrakonda1,
  2. Shashikiran Umakanth2,3
  1. 1Department of Ophthalmology, Dr TMA Pai Rotary Hospital, Karkala, Manipal, Karnataka, India
  2. 2Department of Medicine, Dr TMA Pai Hospital, Udupi, Karnataka, India
  3. 3Department of Medicine, Melaka-Manipal Medical College, Manipal, Karnataka, India
  1. Correspondence to Dr Shashikiran Umakanth, shashikiranu{at}


Acute onset of diplopia associated with high-grade fever, sore throat and cough without features of raised intracranial tension in a young patient is an uncommon presentation. A diagnosis of abducent nerve palsy due to pontine tuberculoma associated with miliary tuberculosis was made based on sputum examination, chest x-ray and MRI. On diagnosis, monocular patching of the left eye was performed to avoid diplopia and primary antitubercular drugs with systemic steroids were given. An unfortunate 48 h delay in starting the antitubercular treatment likely decreased the probability of survival.

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  • Competing interests None.

  • Patient consent Obtained.