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      Tuberculose ocular: relato de casos Translated title: Ocular tuberculosis: case reports

      case-report

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          Abstract

          Os autores relatam dois casos de tuberculose ocular presumida com comprometimento coroidiano. No primeiro caso, um paciente de 43 anos, HIV positivo, com tuberculose pulmonar miliar e tuberculoma cerebral, apresenta um granuloma coroidiano único na região macular do olho esquerdo. No segundo caso, uma paciente de 12 anos, HIV negativa, com tuberculose pulmonar apresenta coroidite multifocal e comprometimento do segmento anterior do olho esquerdo. Ambos os pacientes evoluíram favoravelmente com o tratamento específico, apresentando completa resolução das lesões. As lesões oculares da tuberculose são diversas e devemos continuar atentos a esta enfermidade.

          Translated abstract

          The authors report two cases of presumed ocular tuberculosis with choroidal involvement. In the first case, we describe a 43-year-old male, HIV positive, with pulmonary and cerebral tuberculosis, who presented a single choroidal nodule in the left eye's macula. In the second case, a 12-year-old female with pulmonary tuberculosis presented multifocal choroiditis and anterior involvement of the left eye. Both patients underwent the treatment for tuberculosis and the lesions completely resolved. The ocular lesions of tuberculosis are polymorphic and we must be aware of this disease.

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          Most cited references17

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          Tuberculosis in patients with human immunodeficiency virus infection.

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            Infectious multifocal choroiditis in patients with acquired immune deficiency syndrome.

            The purposes of this study are to determine the incidence of infectious opportunistic choroiditis in patients with the acquired immune deficiency syndrome (AIDS), to study the association of these choroidal infections with systemic dissemination, and to investigate the life expectancy and cause of death in patients with infectious opportunistic choroiditis. A total of 470 eyes of 235 consecutive autopsies of patients with AIDS were examined by histopathologic methods. The clinical charts and autopsy reports of these patients were subsequently reviewed for presence of systemic dissemination of various infectious agents. Of the 235 patients, 18 were found to have infectious choroiditis. The etiologic agents found were: Cryptococcus neoformans, Pneumocystis carinii, Mycobacterium tuberculosis, Histoplasma capsulatum, Candida, Aspergillus fumigatus, Toxoplasma gondii, and Mycobacterium avium-intracellulare. In 15 of these 18 patients, the cause of death was considered to be due to systemic dissemination of the organism causing the choroiditis. Only 4 of the 18 cases of infectious choroiditis were diagnosed during life, and the survival time of these patients after diagnosis was only 25 days. Five of the 18 patients also were found to have cytomegalovirus (CMV) infection of the retina. Multifocal choroiditis due to endogenous infectious emboli in patients with AIDS reflects systemic dissemination and localization of infectious agents predominantly in the choriocapillaris. Early diagnosis and treatment are imperative and may be life-saving.
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              Tuberculoma of the choroid.

              A 22-year-old South American man with known active pulmonary tuberculosis was seen because of marked unilateral loss of vision. A diagnosis of choroidal tuberculoma was made. Resolution of the lesion while under antituberculous medication was documented by the use of serial fundus photographs and fluorescein angiography. The typical presenting features of ocular tuberculosis are discussed. Fluorescein angiography has been performed infrequently in cases of tuberculosis.
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                Author and article information

                Journal
                abo
                Arquivos Brasileiros de Oftalmologia
                Arq. Bras. Oftalmol.
                Conselho Brasileiro de Oftalmologia (São Paulo, SP, Brazil )
                0004-2749
                1678-2925
                December 2003
                : 66
                : 6
                : 887-890
                Affiliations
                [01] orgnameUniversidade Federal do Rio de Janeiro
                [02] orgnameUniversidade Federal do Rio de Janeiro orgdiv1Serviço de Oftalmologia
                [03] orgnameUniversidade Federal do Rio de Janeiro orgdiv1Departamento de Oftalmologia
                [04] orgnameUniversidade Federal de São Paulo
                Article
                S0004-27492003000700028 S0004-2749(03)06600628
                10.1590/S0004-27492003000700028
                1b2c457c-2cf0-49fc-b29c-b1080dc59388

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 17 April 2002
                : 14 May 2003
                : 21 December 2001
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 17, Pages: 4
                Product

                SciELO Brazil

                Categories
                Relatos de Casos

                Coroidite,HIV,Antituberculosos,Relato de caso,Ocular tuberculosis,Uveitis,Choroiditis,Antitubercular agents,Case report,Uveíte,Tuberculose ocular

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