Differential Diagnosis
The patient presents with blurred optic disc margins, hyperthermia, normal visual acuity, and a normal CT scan of the head. Here's a differential diagnosis organized into categories:
- Single most likely diagnosis
- Papilledema due to increased intracranial pressure (ICP) without mass effect: This condition can cause blurred optic disc margins due to swelling of the optic disc. Hyperthermia may be a non-specific symptom, and normal visual acuity is possible in the early stages. A normal CT scan does not rule out increased ICP, as it may not show the underlying cause.
- Other Likely diagnoses
- Optic neuritis: Although typically associated with visual loss, some cases of optic neuritis may present with normal visual acuity. Blurred optic disc margins and hyperthermia could be related to the inflammatory process.
- Migraine with optic disc edema: Migraines can cause increased ICP and optic disc edema, leading to blurred optic disc margins. Hyperthermia may be a non-specific symptom.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Meningitis or encephalitis: These conditions can cause increased ICP, hyperthermia, and optic disc swelling. Although the CT scan is normal, these diagnoses should be considered due to their potential severity and need for prompt treatment.
- Brain tumor or abscess without mass effect: Although the CT scan is normal, it's essential to consider these diagnoses, as they can cause increased ICP and optic disc swelling without significant mass effect.
- Rare diagnoses
- Idiopathic intracranial hypertension (IIH) without typical symptoms: IIH can cause increased ICP and optic disc swelling, but it's often associated with other symptoms like headache and tinnitus.
- Sarcoidosis or other granulomatous diseases: These conditions can cause optic disc swelling and increased ICP, but they are less common and may require further testing for diagnosis.