Optic neuropathy due to brain abscess.

A 26-year-old man went blind as part of a multifocal central nervous system disease. Bilateral optic nerve head pallor developed four weeks later. There had been no papilledema. In this setting, the appearance of optic atrophy without preceding papilledema in part led to the clinical diagnosis of severe disseminated encephalomyelitis. At autopsy multiple brain abscesses were found, including an area of inflammation within the chiasm.