Ocular Tuberculosis in Pediatrics: A Case Report
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , |
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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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 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19245 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19245 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/19245 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 |
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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 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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