Tuberculous Posterior Sclero-Uveitis with Features of Vogt-Koyanagi-Harada Uveitis: An Unusual Case

Patient: Male, 32 Final Diagnosis: Ocular tuberculosis (tuberculous posterior sclero-uveitis with features of Vogt-Koyanagi-Harada uveitis) Symptoms: Pain and progressive visual impairment of his left eye Medication: Systemic anti-tuberculosis treatment (6-month course) Clinical Procedure: Thorough...

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Autores principales: Kalogeropoulos, Dimitrios, Kitsos, George, Konstantinidis, Athanasios, Gartzonika, Constantina, Svarna, Evgenia, Malamos, Konstantinos, Katsanevakis, Emmanouil, Kalogeropoulos, Chris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5391803/
https://www.ncbi.nlm.nih.gov/pubmed/28389634
http://dx.doi.org/10.12659/AJCR.903304
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author Kalogeropoulos, Dimitrios
Kitsos, George
Konstantinidis, Athanasios
Gartzonika, Constantina
Svarna, Evgenia
Malamos, Konstantinos
Katsanevakis, Emmanouil
Kalogeropoulos, Chris
author_facet Kalogeropoulos, Dimitrios
Kitsos, George
Konstantinidis, Athanasios
Gartzonika, Constantina
Svarna, Evgenia
Malamos, Konstantinos
Katsanevakis, Emmanouil
Kalogeropoulos, Chris
author_sort Kalogeropoulos, Dimitrios
collection PubMed
description Patient: Male, 32 Final Diagnosis: Ocular tuberculosis (tuberculous posterior sclero-uveitis with features of Vogt-Koyanagi-Harada uveitis) Symptoms: Pain and progressive visual impairment of his left eye Medication: Systemic anti-tuberculosis treatment (6-month course) Clinical Procedure: Thorough ophthalmological and systemic exploration Specialty: Ophthalmology OBJECTIVE: Rare disease BACKGROUND: Ocular tuberculosis (TB) is a clinical entity that presents with a wide range of clinical manifestations. It is regarded as an extremely challenging condition from the point of view of diagnostic approach and calls for early diagnosis and prompt treatment, as it can potentially lead to blindness. CASE REPORT: This is a case report of a 32-year-old male from southern India who has been living and working in Greece over the last 10 years and presented with 2-week history of pain and progressive visual impairment of his left eye. He underwent a thorough clinical ophthalmological examination and imaging of the fundus, and the findings were consistent with uveitis. However, the manifestations of the inflammation were complicated as they included features that could be attributed mainly to Vogt-Koyanagi-Harada (VKH) disease and tuberculous serpiginous-like uveitis. Therefore, a systemic evaluation, together with specific laboratory and paraclinical investigations, were carried out to define the etiology of the inflammation and develop an optimal therapeutic plan. Taking into account specific findings from the chest imaging, a positive purified protein derivative (PPD) skin test, and sputum cultures positive for Mycobacterium tuberculosis (MTB), we set a diagnosis of posterior sclero-uveitis and started our patient on anti-tuberculous treatment. CONCLUSIONS: This case reveals an atypical manifestation of tuberculous sclero-uveitis imitating Vogt-Koyanagi-Harada disease together with a few characteristics of serpiginous-like tuberculous uveitis, emphasizing the fact that tuberculosis should always be included in the differential diagnosis of uveitis when there is no obvious underlying disease.
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spelling pubmed-53918032017-04-24 Tuberculous Posterior Sclero-Uveitis with Features of Vogt-Koyanagi-Harada Uveitis: An Unusual Case Kalogeropoulos, Dimitrios Kitsos, George Konstantinidis, Athanasios Gartzonika, Constantina Svarna, Evgenia Malamos, Konstantinos Katsanevakis, Emmanouil Kalogeropoulos, Chris Am J Case Rep Articles Patient: Male, 32 Final Diagnosis: Ocular tuberculosis (tuberculous posterior sclero-uveitis with features of Vogt-Koyanagi-Harada uveitis) Symptoms: Pain and progressive visual impairment of his left eye Medication: Systemic anti-tuberculosis treatment (6-month course) Clinical Procedure: Thorough ophthalmological and systemic exploration Specialty: Ophthalmology OBJECTIVE: Rare disease BACKGROUND: Ocular tuberculosis (TB) is a clinical entity that presents with a wide range of clinical manifestations. It is regarded as an extremely challenging condition from the point of view of diagnostic approach and calls for early diagnosis and prompt treatment, as it can potentially lead to blindness. CASE REPORT: This is a case report of a 32-year-old male from southern India who has been living and working in Greece over the last 10 years and presented with 2-week history of pain and progressive visual impairment of his left eye. He underwent a thorough clinical ophthalmological examination and imaging of the fundus, and the findings were consistent with uveitis. However, the manifestations of the inflammation were complicated as they included features that could be attributed mainly to Vogt-Koyanagi-Harada (VKH) disease and tuberculous serpiginous-like uveitis. Therefore, a systemic evaluation, together with specific laboratory and paraclinical investigations, were carried out to define the etiology of the inflammation and develop an optimal therapeutic plan. Taking into account specific findings from the chest imaging, a positive purified protein derivative (PPD) skin test, and sputum cultures positive for Mycobacterium tuberculosis (MTB), we set a diagnosis of posterior sclero-uveitis and started our patient on anti-tuberculous treatment. CONCLUSIONS: This case reveals an atypical manifestation of tuberculous sclero-uveitis imitating Vogt-Koyanagi-Harada disease together with a few characteristics of serpiginous-like tuberculous uveitis, emphasizing the fact that tuberculosis should always be included in the differential diagnosis of uveitis when there is no obvious underlying disease. International Scientific Literature, Inc. 2017-04-08 /pmc/articles/PMC5391803/ /pubmed/28389634 http://dx.doi.org/10.12659/AJCR.903304 Text en © Am J Case Rep, 2017 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
spellingShingle Articles
Kalogeropoulos, Dimitrios
Kitsos, George
Konstantinidis, Athanasios
Gartzonika, Constantina
Svarna, Evgenia
Malamos, Konstantinos
Katsanevakis, Emmanouil
Kalogeropoulos, Chris
Tuberculous Posterior Sclero-Uveitis with Features of Vogt-Koyanagi-Harada Uveitis: An Unusual Case
title Tuberculous Posterior Sclero-Uveitis with Features of Vogt-Koyanagi-Harada Uveitis: An Unusual Case
title_full Tuberculous Posterior Sclero-Uveitis with Features of Vogt-Koyanagi-Harada Uveitis: An Unusual Case
title_fullStr Tuberculous Posterior Sclero-Uveitis with Features of Vogt-Koyanagi-Harada Uveitis: An Unusual Case
title_full_unstemmed Tuberculous Posterior Sclero-Uveitis with Features of Vogt-Koyanagi-Harada Uveitis: An Unusual Case
title_short Tuberculous Posterior Sclero-Uveitis with Features of Vogt-Koyanagi-Harada Uveitis: An Unusual Case
title_sort tuberculous posterior sclero-uveitis with features of vogt-koyanagi-harada uveitis: an unusual case
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5391803/
https://www.ncbi.nlm.nih.gov/pubmed/28389634
http://dx.doi.org/10.12659/AJCR.903304
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