MOGAD optic neuritis post enterovirus meningitis: a new association

Introduction Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare autoimmune demyelinating disorder of the central nervous system, typically presenting with optic neuritis, transverse myelitis or acute disseminated encephalomyelitis. While viral triggers such as Epstein-Barr virus and adenovirus have been reported, an association with enterovirus meningitis is not well documented. Case presentation We report a 17-year-old female who presented with enterovirus meningitis confirmed by cerebrospinal fluid PCR and leptomeningeal enhancement on MRI. One week later, she developed right optic neuritis with MRI-confirmed optic nerve enhancement. Serum myelin oligodendrocyte glycoprotein-IgG was positive (1:160), confirming MOGAD. She fully recovered after intravenous steroids and oral taper. Conclusion This case suggests enterovirus meningitis may trigger MOGAD and highlights the need to consider post-infectious demyelination in patients with new neurological symptoms following viral meningitis.