Paradoxical Reaction in Intraocular Tuberculosis: Report of Three Cases.

Autor:	Gusmão CC; Faculdade de Medicina, LIM 33, Department of Ophthalmology, Universidade de São Paulo, São Paulo, Brazil.; Faculdade de Ciências Médicas, Department of Ophthalmology, Universidade Estadual de Campinas, Campinas, Brazil., Dos Reis R; Faculdade de Medicina, LIM 33, Department of Ophthalmology, Universidade de São Paulo, São Paulo, Brazil.; Faculdade de Ciências Médicas, Department of Ophthalmology, Universidade Estadual de Campinas, Campinas, Brazil., Litvoc MN; Faculdade de Medicina, Division of Infectious Diseases, Universidade de São Paulo, São Paulo, Brazil., Hirata CE; Faculdade de Medicina, LIM 33, Department of Ophthalmology, Universidade de São Paulo, São Paulo, Brazil., Yamamoto JH; Faculdade de Medicina, LIM 33, Department of Ophthalmology, Universidade de São Paulo, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Ocular immunology and inflammation [Ocul Immunol Inflamm] 2024 Dec; Vol. 32 (10), pp. 2562-2567. Date of Electronic Publication: 2024 Jul 09.
DOI:	10.1080/09273948.2024.2372314
Abstrakt:	Purpose: To present paradoxical reaction (PR) in three cases with ocular tuberculosis (OTB) treated with antitubercular therapy (ATT), highlighting diagnostic challenges and treatment strategies. Methods: We retrospectively reviewed clinical records of three OTB patients presenting with paradoxical worsening after ATT initiation at two Brazilian university hospitals. Results: The patients (2 males, 1 female) experienced worsening clinical presentation (increased inflammation, vision loss) within two to three weeks after initiating ATT. One patient who was HIV-positive with unilateral multifocal choroiditis developed PR soon after starting antiretroviral therapy. The second patient presented with a choroidal tuberculoma in both eyes. The third patient also had multifocal choroiditis and developed a localized choroidal elevation with a double-layer sign as a manifestation of PR. All patients were maintained on ATT therapy in association with corticosteroids and experienced improvement of inflammatory signs. Conclusion: This case series highlights the potential for PR in OTB patients. Close monitoring and prompt therapeutic adjustments are crucial for management success.
Databáze:	MEDLINE
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