[A case of miliary tuberculosis with brain tuberculoma, following intraocular tuberculosis].
A 52-year-old woman with visual loss of her left eye consulted a ophthalmology clinic. She was conducted left vitrectomy and administered corticosteroid under the diagnosis of uveitis of unknown cause. But her visual acuity was not improved. Although re-surgery was planned, pus retention was found in her left eye. After her left eye was resected, fever and general malaise appeared suddenly. Her chest X-ray film revealed diffuse micronodular opacities. Acid-fast bacilli were detected from her sputum and identified to be Mycobacterium tuberculosis. She was diagnosed miliary tuberculosis, and then antituberculous chemotherapy consisting of 4 drugs was started. Granulomatous inflammation destructing retina and numerous acid-fact bacilli were found in histologic examination of the resected eye. This case was thought to be miliary tuberculosis disseminated from intraocular tuberculosis. After 2 months of therapy, neurologic symptoms which might be caused by brain tuberucloma appeared and deteriorated rapidly. But by adding corticosteroid to antituberculous therapy, symptoms were diminished gradually.
Takakura
S
S
Department of Pulmonary Medicine, Kobe City General Hospital, Japan.
Tanaka
E
E
Kimoto
T
T
Watanabe
I
I
Matsumoto
H
H
Tsuyuguchi
K
K
Niimi
A
A
Suzuki
K
K
Amitani
R
R
Kuze
F
F
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D000995:Antitubercular Agents / Q000008:administration & dosage; D001623:Betamethasone / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008875:Middle Aged; D016862:Tuberculoma, Intracranial / Q000188:drug therapy / Q000209:etiology*; D014391:Tuberculosis, Miliary / Q000188:drug therapy / Q000209:etiology*; D014392:Tuberculosis, Ocular / Q000150:complications* / Q000188:drug therapy
D000893:Anti-Inflammatory Agents; D000995:Antitubercular Agents; D001623:Betamethasone