Yaghoubi Gholam Hossein, Abedi Farshid, Ziaee Masoud, Norouzpour Amir
Birjand University of Medical Sciences, Department of Ophthalmology, Birjand, Iran
Birjand University of Medical Sciences, Department of Infectious Diseases, Birjand, Iran
Turk J Ophthalmol. 2019 Dec 31;49(6):361-363. doi: 10.4274/tjo.galenos.2019.55889.
can spread through the entire body but rarely involves the eye. We report a patient with endophthalmitis in one eye and simultaneous retinal vasculitis in the fellow eye. Systemic work-up suggested infective endopericarditis. Polymerase chain reaction analyses of the vitreous and pericardial fluid were positive for . We initiated a four-drug antituberculous treatment regimen (isoniazid, ethambutol, pyrazinamide, and rifampin). After two weeks, we discontinued all the medications due to drug-induced hepatitis. We restarted isoniazid and rifampin, but hepatitis recurred. Finally, we chose isoniazid/ethambutol combination for 18 months, and also administered short-term systemic corticosteroid. His vision improved considerably with no recurrence of hepatitis or tuberculosis for 3 years after completion of treatment. Ocular tuberculosis can masquerade as other causes of intraocular inflammation, and a medical team consisting of an ophthalmologist and an infectious disease specialist might be needed for the diagnosis and management.
可播散至全身，但很少累及眼部。我们报告了一名患者，其一只眼发生眼内炎，另一只眼同时发生视网膜血管炎。全身检查提示感染性心内膜炎。玻璃体和心包液的聚合酶链反应分析呈阳性。我们启动了四联抗结核治疗方案（异烟肼、乙胺丁醇、吡嗪酰胺和利福平）。两周后，由于药物性肝炎，我们停用了所有药物。我们重新开始使用异烟肼和利福平，但肝炎复发。最后，我们选择异烟肼/乙胺丁醇联合用药18个月，并短期给予全身糖皮质激素治疗。治疗完成后3年，他的视力有显著改善，肝炎和结核病均未复发。眼部结核可能伪装成其他眼内炎症原因，诊断和管理可能需要由眼科医生和传染病专家组成的医疗团队。
