Tubercular serpiginous-like choroiditis

BMJ Case Rep. 2011 Oct 28:2011:bcr0820114654. doi: 10.1136/bcr.08.2011.4654.

Abstract

Choroidal tuberculosis (TB) infection may present itself as a diffuse choroiditis that resembles serpiginous choroiditis, usually treated with immunossupressants. Recent studies have demonstrated that patients with serpiginous-like choroiditis and evidence of systemic or latent TB are best treated with antituberculosis treatment (ATT) in addition to the corticosteroid therapy. The authors present a case of a 58-year-old man with decreased vision in his left eye. His best-corrected visual acuity was 20/20 right eye and 20/200 left eye. Funduscopic examination revealed a diffuse choroiditis. Mantoux skin test showed an area of induration measuring 30×35 mm and the patient started ATT with complete resolution of retinal lesions after 2 weeks of treatment. His final visual acuity was 20/25 in the left eye with no recurrences over a follow-up of 6 months. The use of ATT in these patients is likely to reduce active inflammation and eliminate future recurrences.

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents / therapeutic use*
  • Choroiditis / drug therapy
  • Choroiditis / microbiology*
  • Choroiditis / pathology
  • Drug Combinations
  • Humans
  • Isoniazid / therapeutic use*
  • Male
  • Middle Aged
  • Pyrazinamide / therapeutic use*
  • Rifampin / therapeutic use*
  • Tuberculosis, Ocular / complications*
  • Tuberculosis, Ocular / diagnosis
  • Tuberculosis, Ocular / drug therapy*
  • Vision Disorders / microbiology

Substances

  • Antitubercular Agents
  • Drug Combinations
  • isoniazid, pyrazinamide, rifampin drug combination
  • Pyrazinamide
  • Isoniazid
  • Rifampin