Ocular Tuberculosis in Pediatrics: A Case Report

Detalhes bibliográficos
Autor(a) principal: Vieira, Paula Manuel
Data de Publicação: 2023
Outros Autores: Zilhão, Carla, Miranda, Vasco
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19245
Resumo: A 17-year-old male was taken to the emergency department for decreased left visual acuity and floaters beginning that same day. There was a history of exposure to pulmonary tuberculosis five years before (mother as index case) followed by a four-month period of isoniazid prophylaxis. The ophthalmic examination showed posterior and intermediate uveitis in the left eye. Laboratory tests were normal; IgG for herpes simplex 1 was positive and both the varicella-zoster virus and remaining serologic tests were negative. Chest radiography was normal. Two weeks later, an epiretinal membrane with risk of tractional retinal detachment was observed. The Mantoux tuberculin skin test showed an induration of 15 mm and the IGRA test was positive. Sputum and vitreous humor samples were collected. Quadruple therapy and prednisolone were started. Ten days later, a posterior vitreous detachment with underlying vitreous hematoma was observed. Posterior vitrectomy and peripheral endolaser were performed without complications. One month later, the microbiological results became available, with the identification of Mycobacterium tuberculosis. Corticosteroids were weaned progressively. Antituberculous drugs were maintained for six months. The patient made a full recovery.
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spelling Ocular Tuberculosis in Pediatrics: A Case ReportTuberculose Ocular em Pediatria: Relato de CasoAdolescentTuberculosis, Ocular/diagnosisUveitis/diagnosisAdolescenteTuberculose Ocular/diagnósticoUveíte/diagnósticoA 17-year-old male was taken to the emergency department for decreased left visual acuity and floaters beginning that same day. There was a history of exposure to pulmonary tuberculosis five years before (mother as index case) followed by a four-month period of isoniazid prophylaxis. The ophthalmic examination showed posterior and intermediate uveitis in the left eye. Laboratory tests were normal; IgG for herpes simplex 1 was positive and both the varicella-zoster virus and remaining serologic tests were negative. Chest radiography was normal. Two weeks later, an epiretinal membrane with risk of tractional retinal detachment was observed. The Mantoux tuberculin skin test showed an induration of 15 mm and the IGRA test was positive. Sputum and vitreous humor samples were collected. Quadruple therapy and prednisolone were started. Ten days later, a posterior vitreous detachment with underlying vitreous hematoma was observed. Posterior vitrectomy and peripheral endolaser were performed without complications. One month later, the microbiological results became available, with the identification of Mycobacterium tuberculosis. Corticosteroids were weaned progressively. Antituberculous drugs were maintained for six months. The patient made a full recovery.Adolescente, 17 anos, sexo masculino, foi levado ao serviço de urgência por hipovisão esquerda e ‘moscas volantes’ de aparecimento nesse dia. Referiu contacto com tuberculose pulmonar quinze anos antes (mãe como caso índex); realizou profilaxia com isoniazida durante quatro meses. O exame oftalmológico apresentava uveíte posterior e intermédia à esquerda. O estudo analítico não apresentava alterações. A IgG para herpes simplex 1 veio positiva e as restantes serologias incluindo vírus varicela-zoster vieram negativas. A radiografia tórax não apresentava alterações. Após duas semanas, foi observada uma membrana epirretiniana com risco de descolamento tracional da retina. A prova de Mantoux apresentava enduração de 15 mm e o teste IGRA veio positivo. Foram colhidas secreções respiratórias e humor vítreo para cultura. Foi iniciada terapêutica quádrupla e prednisolona. Dez dias depois verificou-se um descolamento hialóide posterior com hematoma vítreo subjacente. Foi então submetido a vitrectomia posterior e endolaser periférico sem intercorrências. Um mês depois foram conhecidos os resultados dos exames culturais com crescimento de Mycobacterium tuberculosis. Iniciou desmame progressivo da corticoterapia. Realizou terapêutica antibacilar durante seis meses. Verificou-se resolução completa com normalização da acuidade visual.Ordem dos Médicos2023-04-19info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19245Acta Médica Portuguesa; Vol. 36 No. 10 (2023): October; 683-686Acta Médica Portuguesa; Vol. 36 N.º 10 (2023): Outubro; 683-6861646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19245https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19245/15114Direitos de Autor (c) 2023 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessVieira, Paula ManuelZilhão, CarlaMiranda, Vasco2023-10-08T03:00:14Zoai:ojs.www.actamedicaportuguesa.com:article/19245Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:50:10.375468Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Ocular Tuberculosis in Pediatrics: A Case Report
Tuberculose Ocular em Pediatria: Relato de Caso
title Ocular Tuberculosis in Pediatrics: A Case Report
spellingShingle Ocular Tuberculosis in Pediatrics: A Case Report
Vieira, Paula Manuel
Adolescent
Tuberculosis, Ocular/diagnosis
Uveitis/diagnosis
Adolescente
Tuberculose Ocular/diagnóstico
Uveíte/diagnóstico
title_short Ocular Tuberculosis in Pediatrics: A Case Report
title_full Ocular Tuberculosis in Pediatrics: A Case Report
title_fullStr Ocular Tuberculosis in Pediatrics: A Case Report
title_full_unstemmed Ocular Tuberculosis in Pediatrics: A Case Report
title_sort Ocular Tuberculosis in Pediatrics: A Case Report
author Vieira, Paula Manuel
author_facet Vieira, Paula Manuel
Zilhão, Carla
Miranda, Vasco
author_role author
author2 Zilhão, Carla
Miranda, Vasco
author2_role author
author
dc.contributor.author.fl_str_mv Vieira, Paula Manuel
Zilhão, Carla
Miranda, Vasco
dc.subject.por.fl_str_mv Adolescent
Tuberculosis, Ocular/diagnosis
Uveitis/diagnosis
Adolescente
Tuberculose Ocular/diagnóstico
Uveíte/diagnóstico
topic Adolescent
Tuberculosis, Ocular/diagnosis
Uveitis/diagnosis
Adolescente
Tuberculose Ocular/diagnóstico
Uveíte/diagnóstico
description A 17-year-old male was taken to the emergency department for decreased left visual acuity and floaters beginning that same day. There was a history of exposure to pulmonary tuberculosis five years before (mother as index case) followed by a four-month period of isoniazid prophylaxis. The ophthalmic examination showed posterior and intermediate uveitis in the left eye. Laboratory tests were normal; IgG for herpes simplex 1 was positive and both the varicella-zoster virus and remaining serologic tests were negative. Chest radiography was normal. Two weeks later, an epiretinal membrane with risk of tractional retinal detachment was observed. The Mantoux tuberculin skin test showed an induration of 15 mm and the IGRA test was positive. Sputum and vitreous humor samples were collected. Quadruple therapy and prednisolone were started. Ten days later, a posterior vitreous detachment with underlying vitreous hematoma was observed. Posterior vitrectomy and peripheral endolaser were performed without complications. One month later, the microbiological results became available, with the identification of Mycobacterium tuberculosis. Corticosteroids were weaned progressively. Antituberculous drugs were maintained for six months. The patient made a full recovery.
publishDate 2023
dc.date.none.fl_str_mv 2023-04-19
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dc.language.iso.fl_str_mv por
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19245/15114
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2023 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2023 Acta Médica Portuguesa
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 36 No. 10 (2023): October; 683-686
Acta Médica Portuguesa; Vol. 36 N.º 10 (2023): Outubro; 683-686
1646-0758
0870-399X
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