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无肺部原发灶的眼部结核

Ocular Tuberculosis Without a Lung Primary.

作者信息

Nandu Nitish Singh, Bavanasi Aamani, Wajahat Rana

机构信息

Internal Medicine, Chicago Medical School, Rosalind Franklin University, North Chicago, USA.

Internal Medicine, MNR Medical College, Fasalwadi, IND.

出版信息

Cureus. 2020 May 1;12(5):e7920. doi: 10.7759/cureus.7920.

Abstract

Tuberculosis (TB) is a multisystem infectious disease caused by , which primarily affects the lungs. It is the leading infectious cause of morbidity and mortality worldwide with significant prevalence in the developing countries. However, extrapulmonary manifestations can be seldom seen in a few patients with disseminated TB or with localized disease. These manifestations depend on various comorbidities and the immune status of the patients. Extrapulmonary tuberculosis (EPTB) constitutes multiple cases of TB in the immunocompetent and immunocompromised populace. The clinical presentation of EPTB is atypical and can be challenging to confirm, often leading to delayed diagnosis and treatment. This, in particular, is true with ocular TB. The incidence of ocular TB is uncertain due to difficulties in ocular sampling for microbiology and the lack of definitive diagnostic criteria. Ocular TB can present in a fashion similar to other conditions causing ocular inflammation. It is crucial for physicians to consider this diagnosis in their differential, as ocular TB can present in a fashion similar to that of more common conditions causing ocular inflammation. We present a rare case of ocular uveitis secondary to TB in an asymptomatic patient without a lung primary, complicated by an unmasked allergy to first-line anti-TB medication.

摘要

结核病(TB)是一种由[具体病因未给出]引起的多系统传染病,主要影响肺部。它是全球发病和死亡的主要感染原因,在发展中国家发病率很高。然而,在少数播散性结核病患者或局限性疾病患者中,肺外表现很少见。这些表现取决于各种合并症和患者的免疫状态。肺外结核病(EPTB)在免疫功能正常和免疫功能低下人群中构成多例结核病。EPTB的临床表现不典型,确诊可能具有挑战性,常常导致诊断和治疗延迟。眼部结核病尤其如此。由于眼部微生物采样困难以及缺乏明确的诊断标准,眼部结核病的发病率尚不确定。眼部结核病的表现可能与其他引起眼部炎症的疾病相似。对于医生来说,在鉴别诊断时考虑这种诊断至关重要,因为眼部结核病的表现可能与更常见的引起眼部炎症的疾病相似。我们报告一例罕见的无症状患者眼部葡萄膜炎继发于结核病,无肺部原发灶,且并发对一线抗结核药物的隐匿性过敏。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/71a6/7263713/976544f2ec37/cureus-0012-00000007920-i01.jpg

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