Infectious chorioretinitis in an immunocompetent patient: A diagnostic dilemma
| Autor: | HN Madhavan, B Sowkath Ali, Sudha K Ganesh |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
DNA Bacterial Male medicine.medical_specialty medicine.medical_treatment polymerase chain reaction Visual Acuity Vitrectomy Tuberculosis Ocular Real-Time Polymerase Chain Reaction Diagnosis Differential 03 medical and health sciences Quadrant (abdomen) Immunocompromised Host 0302 clinical medicine lcsh:Ophthalmology Ophthalmology medicine Electroretinography Humans 030203 arthritis & rheumatology medicine.diagnostic_test business.industry Panuveitis Chorioretinitis Paradoxical reaction Goldmann-Witmer coefficient Mantoux test Mycobacterium tuberculosis medicine.disease Toxoplasmosis Surgery lcsh:RE1-994 030221 ophthalmology & optometry Differential diagnosis business Brief Communications toxoplasmosis |
| Zdroj: | Indian Journal of Ophthalmology Indian Journal of Ophthalmology, Vol 65, Iss 10, Pp 1043-1046 (2017) |
| ISSN: | 1998-3689 0301-4738 |
| Popis: | A 44-year-old male presented with a history of defective vision in the right eye for the past 5 months with the previous history of tubercular cervical lymphadenitis. On examination, right eye revealed panuveitis with dense vitritis and chorioretinitis in the superotemporal quadrant. His Mantoux test was positive (25 mm × 25 mm induration), QuantiFERON-TB Gold was test positive, aqueous aspirate was positive for Mycobacterium tuberculosis genome, negative for viruses and toxoplasma, and hence he was initiated on four-drug antitubercular therapy (ATT) with oral steroids. On follow-up, he had worsening of vitritis and intravenous methylprednisolone was given suspecting paradoxical reaction to ATT; however, a repeat AC tap was positive for toxoplasma B1 genome, IgG antitoxoplasma antibody was also positive in serum and aqueous; hence, we switched to systemic antitoxoplasma therapy. He underwent a therapeutic vitrectomy along with intravitreal clindamycin and dexamethasone for persistent vitreous membranes and vitritis. The patient responded well to the treatment with a reduction in vitritis and scarring of the lesion. |
| Databáze: | OpenAIRE |
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