健康年轻女性的脉络膜下腔粟粒状结核，由牛分枝杆菌引起。

SUBFOVEAL CHOROIDAL TUBERCULOMA IN A HEALTHY YOUNG WOMAN CAUSED BY MYCOBACTERIUM BOVIS.

机构信息

Department of Ophthalmology, Helios HSK, Wiesbaden, Germany.

出版信息

Retin Cases Brief Rep. 2024 May 1;18(3):323-327. doi: 10.1097/ICB.0000000000001377.

DOI:10.1097/ICB.0000000000001377

PMID:36800533

Abstract

PURPOSE

To describe a case of a macular tuberculoma in a young and healthy woman after developing a tuberculous lymphadenitis caused by Mycobacterium bovis .

METHODS

Retrospective case report.

RESULTS

Tuberculous lymphadenitis caused by M. bovis was detected after biopsy and histological examination as well as polymerase chain reaction test testing of cervical lymph nodes in a 20-year-old patient. An interferon gamma was positive. Shortly starting antitubercular therapy, the patient developed visual deterioration caused by a single yellowish subretinal structure in the macula of the right eye. Optical coherence tomography showed a dome-shaped, hyperreflective, subfoveal choroidal lesion with subtle subretinal fluid. Antitubercular therapy with isoniazid, rifampicin, ethambutol, and pyrazinamide was performed, and the deescalation therapy with isoniazid and rifampicin was extended to 7 months. Further examinations showed regression of choroidal tuberculoma to a scar.

CONCLUSION

This is the first reported case of choroidal tuberculoma after tuberculous lymphadenitis caused by M. bovis .

摘要

目的

描述一例年轻健康女性在感染牛分枝杆菌引起结核性淋巴结炎后发生黄斑结核瘤的病例。

方法

回顾性病例报告。

结果

20 岁患者经颈淋巴结活检和组织学检查以及聚合酶链反应检测发现牛分枝杆菌引起的结核性淋巴结炎。干扰素-γ阳性。开始抗结核治疗后不久，该患者右眼黄斑区出现单个黄色的视网膜下结构，导致视力下降。光学相干断层扫描显示一个圆顶状、高反射性、位于黄斑下的脉络膜病变，伴有轻微的视网膜下积液。给予异烟肼、利福平、乙胺丁醇和吡嗪酰胺抗结核治疗，并将异烟肼和利福平的降级治疗延长至 7 个月。进一步检查显示脉络膜结核瘤消退为瘢痕。