Sungur Gulten Karatas, Hazirolan Dicle, Gurbuz Yunus, Unlu Nurten, Duran Serkan, Duman Sunay
1st Ophthalmology Department, Ankara Training and Research Hospital, Ankara, Turkey.
Can J Ophthalmol. 2009 Oct;44(5):598-601. doi: 10.3129/i09-019.
To report the ocular findings associated with brucellosis.
Cohort study.
One hundred thirty-two patients with the diagnosis of brucellosis.
Ocular manifestations of 132 patients with brucellosis admitted to the Uveitis-Behçet Service of Ophthalmology Department at the Ankara Education and Research Hospital in Turkey between May 1992 and May 2006 were evaluated prospectively. The diagnosis of brucellosis was based on clinical signs, Brucella agglutination tests, and blood cultures.
Ocular involvement was detected in 21% of brucellosis patients. The most frequent manifestations were anterior uveitis (41%) and choroiditis (32%), followed by panuveitis (9%), papilledema (9%), and retinal hemorrhages (9%). Forty-one percent of these patients were in the acute stage and 59% were in the chronic stage of brucellosis. Interestingly, all the patients with anterior uveitis were in the acute stage and all the other patients with choroiditis, papilledema, and retinal hemorrhages were in the chronic stage. All patients responded well to systemic antibiotic treatment along with topical or systemic corticosteroid treatment. No recurrence of ocular manifestations was detected during the follow-up period, after completion of a 2-month systemic antibiotic treatment.
Because ocular involvement of brucellosis is frequent in endemic regions, detailed ophthalmic examination of all patients with brucellosis should be done routinely. Ocular brucellosis should be considered in the differential diagnosis of all forms of uveitis or choroiditis in endemic regions, and these patients should undergo serologic screening for brucellosis.
报告与布鲁氏菌病相关的眼部表现。
队列研究。
132例诊断为布鲁氏菌病的患者。
对1992年5月至2006年5月期间在土耳其安卡拉教育与研究医院眼科葡萄膜炎-白塞病科住院的132例布鲁氏菌病患者的眼部表现进行前瞻性评估。布鲁氏菌病的诊断基于临床体征、布鲁氏菌凝集试验和血培养。
21%的布鲁氏菌病患者存在眼部受累。最常见的表现为前葡萄膜炎(41%)和脉络膜炎(32%),其次是全葡萄膜炎(9%)、视乳头水肿(9%)和视网膜出血(9%)。这些患者中41%处于布鲁氏菌病急性期,59%处于慢性期。有趣的是,所有前葡萄膜炎患者均处于急性期,而所有其他脉络膜炎、视乳头水肿和视网膜出血患者均处于慢性期。所有患者在接受全身抗生素治疗以及局部或全身糖皮质激素治疗后反应良好。在完成2个月的全身抗生素治疗后,随访期间未发现眼部表现复发。
由于在流行地区布鲁氏菌病眼部受累较为常见,应对所有布鲁氏菌病患者常规进行详细的眼科检查。在流行地区,对于所有类型的葡萄膜炎或脉络膜炎进行鉴别诊断时均应考虑眼部布鲁氏菌病,并且这些患者应接受布鲁氏菌病的血清学筛查。