Bilateral Bouchut Tuberculoma Complicating Multifocal Tuberculosis: A Case Report
Asian Journal of Research and Reports in Ophthalmology, Volume 6, Issue 1,
Page 42-48
Abstract
Tuberculosis is a serious infection and remains a major cause of worldwide mortality and morbidity. Declared by the World Health Organization (WHO) an "urgent global health problem" in 1993. In Morocco, there are about 25,000 new cases / year. Extra-pulmonary localizations represent 35% of all damage, of which 1 to 2% are ocular damage. The purpose of this clinical case is to underline the value of the ophthalmological examination, retinography as well as fluorescein angiography in the orientation of the diagnosis of tuberculosis.
We report the case of a 29-year-old immunocompetent patient, without any notion of tuberculosis contagion, hospitalized for a week in the pulmonology department for management of multifocal tuberculosis associating a microscopy-negative and culture positive pulmonary tuberculosis and multifocal tuberculous spondylodiscitis. A progressive and bilateral decrease in his visual acuity was reported one week after his hospitalization, prompting an ophthalmological consultation which objectified through fundus examination, retinography and fluorescein angiography the presence of bilateral Bouchut's tuberculoma. The patient is put on antitubercular treatment for a period of nine months associated with corticosteroid therapy and vitamin therapy.
In Morocco, tuberculosis continues to surprise as well by its extension affecting the debilitated subject and the immunocompetent subject, as by its various presentations including the ocular involvement that must be sought by a careful and systematic ophthalmological examination. Bouchut's tuberculoma can be a valuable aid in the diagnosis of multifocal tuberculosis by a simple examination of the fundus.
- Bouchut’s tuberculoma
- multifocal tuberculosis
- fundus examination
- retinography
- fluorescein angiography
- antitubercular treatment
How to Cite
References
Laktaoui A, Naoumi A, Reda K, Kriet M, Elouarsani A, Khayati A, Elharradi A, Rouimi A, Douhal A, Mounahc J, Houmadi A. Macular tuberculosis and optic neuritis: rare association during tuberculous meningoencephalitis. J Fr Ophthalmol. 2009 Nov;32(9):673–8. [PubMed] [Google Scholar]
Karim A, Laghmari M, Boutimzine N, Lamarti A, Ibrahimy W, Essakali N, et al. Pseudotumoral choroidal granuloma revealing tuberculosis: report of a case. J Fr Ophthalmol. 2003 Jun;26(6):614–7. [PubMed] [Google Scholar]
Benchekroun S, El Mansouri Y, Rachid R, El Belhadji M, Laouissi N, Zaghloul K, et al. Pseudotumoral choroidal granuloma in miliary tuberculosis. J Fr Ophthalmol. 1999 Aug-Sep;22(7):771–5.[PubMed] [Google Scholar]
El Bakkali M, Halhal M, Chefchaouni M, Belmekki M, Abdellah H, Berraho A. Tuberculous uveitis. J Fr Ophthalmol. 2001 Apr;24(4):396-9. PubMed | Google Scholar.
Trad S, Saadoun D, Errera MH, Abad S, Bielefel P, Terrada C, Sène D, Bodaghi B, Sève P. Ocular tuberculosis. The Journal of Internal Medicine. 2018;39:755–764 761762.
Helm CJ, Holland GN. Ocular tuberculosis. Surv Ophthalmol. 1993;38: 229-51.
Cangemi FE, Frudman AH, Josephberg R. Tuberculoma of choroid. Ophthalmology. 1980;87:252-6.
Ernst JD, Trevejo-Nunez G, Banaiee N. Genomics and the evolution, pathogenesis, and diagnosis of tuberculosis. J Clin Invest. 2007;117: 1738-1745.
Gupta V, Gupta A, Rao NR. Intraocular tuberculosisan update. Surv Ophthalmol. 2007;52:561-587.
Gupta A, Gupta V, Arora S et al. PCR-positive tubercular retinal vasculitis. Clinical characteristics and management. Retina. 2001;21:435-444.
Bouza E, Merino P, Muñoz P, Sanchez-Carrillo C, Yáñez J, Cortés C. Ocular tuberculosis: A prospective study in a general hospital. Medicine (Baltimore). 1997 Jan;76(1):53–61. [PubMed] [Google Scholar]
Chung YM, Shiang Yeh T, Shwn Jiuan Sheu S. Macular subretinal neovascularization in choroidal tuberculosis. Ann Ophthalmol. 1989;21: 225-9.
Biswas J, Madhavan HN, Gopal L, Sengamedu S. Intraocular tuberculosis. Clinicopathologic study of five cases. Retina. 1995;15:461-8.
Recilla-Gispert C, Ortega-Lamoceu G, Arehlanes-Garcia L, Herrera Barnes T. Chorioretinitis secondary to Mycobacterium tuberculosis in acquired immune deficiency syndrome. Retina. 1997;17:437-9.
Barondes MJ, Sponsels WE, Stevens TS, Plotnik RD. Tuberculous choroiditis diagnosed by chorioretinal endobiopsy. Am J Ophthalmol. 1991; 91:460-1.
Benchekroun S, El Mansouri Y, Rachid R, El Belhadji M, Laouissi N, Zaghloul K, Amraoui A. Pseudotumoral choroidal granuloma in miliary tuberculosis. French Journal of Ophthalmology.1999; 22:771. DOI: JFO-07-1999-22-7-0181-5512-101019-ART10.
Lino A, Lalande V, Guetta A, Lebeau B, Heron E, Chouaid C. Diagnosis of tuberculous uveitis: interest of gamma interferon tests. Rev Mal Respir. 2011;28: 317–21.
Khochtali S, Gargouri S, Abroug N, Ksiaa I, Attia S, Sellami D, et al. The spectrum of presumed tubercular uveitis in Tunisia. North Africa. Int Ophthalmol. 2015;35: 663–71.
Gineys R, Bodaghi B, Carcelain G, Cassoux N, Boutin LTH, Amoura Z, et al. QuantiFERON-TB gold cut-off value: implications for the management of tuberculosis-related ocular inflammation. Am J Ophthalmol. 2011;152:433– 40.
Koubaa M, et al. Ocular tuberculosis: a series of 14 cases. Rev Med Internal; 2017. DOI:https://doi.org/10.1016/j.revmed.2018.02.014.
Agrawal R, Gupta B, Gonzalez-Lopez JJ, Rahman F, Phatak S, Triantafyllopoulou I, et al. The role of anti-tubercular therapy in patients with presumed ocular tuberculosis. Ocul Immunol Inflamm. 2015; 23:40–6.
Gupta V, Bansal R, Gupta A. Continuous progression of tubercular serpiginous-like choroiditis after initiating antituberculosis treatment. Am J Ophthalmol. 2011;152: 857–63.
Agrawal R, Gupta B, Gonzalez-Lopez JJ, Rahman F, Phatak S, Triantafyllopoulou I, et al. The role of anti-tubercular therapy in patients with presumed ocular tuberculosis. Ocul Immunol Inflamm. 2015; 23:40–6.
Agrawal R, Gonzalez-Lopez JJ, Nobre-Cardoso J, Gupta B, Grant R, Addison PK, et al. Predictive factors for treatment failure in patients with presumed ocular tuberculosis in an area of low endemic prevalence. Br J Ophthalmol. 2016;100: 348–55.
Cordero-Coma M, Calleja S, Torres HE, del Barrio I, Franco M, Yilmaz T, et al. The value of an immune response to Mycobacterium tuberculosis in patients with chronic posterior uveitis revisited: utility of the new IGRAs. Eye (London). 2010;24:36–43.
-
Abstract View: 15 times
PDF Download: 11 times
