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

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ABSTRACT

Patient: male, 32"/> MedlinePlus

(A) Chest X-ray: Bilateral hilar lymphadenopathy. (B, C) CT scan: multiple pulmonary infiltrates consistent with pulmonary tuberculosis.
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f4-amjcaserep-18-367: (A) Chest X-ray: Bilateral hilar lymphadenopathy. (B, C) CT scan: multiple pulmonary infiltrates consistent with pulmonary tuberculosis.

Mentions: Results of laboratory investigations, including full blood count and biochemistry assays, were unremarkable and no pathogens were detected in blood, sputum, and urine cultures. Results of further investigations were normal, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum rheumatoid factor (RF), angiotensin-converting enzyme (ACE), antinu-clear antibodies, antineutrophilic cytoplasmic antibodies (p and c), ELISA for human immunodeficiency virus (1 and 2), serology for syphilis (TPHA: Treponema pallidum hemagglutinin antigen, VDRL: Venereal Disease Research Laboratory), and viral hepatitis (B and C). However, because the chest X-ray revealed bilateral hilar lymphadenopathy (Figure 4A), we requested a chest CT scan to obtain a more detailed imaging of the lungs. The CT scan illustrated multiple pulmonary infiltrates consistent with pulmonary tuberculosis (Figure 4B, 4C). Therefore, although our patient was vaccinated at childhood with BCG, we performed a tuberculin skin test, and the result was strongly positive (induration diameter: 25 mm). This result, together with positive sputum cultures for Mycobacterium tuberculosis and the radiologic findings, in combination with his migration from southern India, which is regarded as an endemic area for tuberculosis, led us to a diagnosis of tuberculous uveitis; specifically, the final diagnosis was tuberculous posterior sclerouveitis, mimicking mainly VKH disease, with some features of tuberculous serpiginous-like uveitis.


Tuberculous Posterior Sclero-Uveitis with Features of Vogt-Koyanagi-Harada Uveitis: An Unusual Case
(A) Chest X-ray: Bilateral hilar lymphadenopathy. (B, C) CT scan: multiple pulmonary infiltrates consistent with pulmonary tuberculosis.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC5391803&req=5

f4-amjcaserep-18-367: (A) Chest X-ray: Bilateral hilar lymphadenopathy. (B, C) CT scan: multiple pulmonary infiltrates consistent with pulmonary tuberculosis.
Mentions: Results of laboratory investigations, including full blood count and biochemistry assays, were unremarkable and no pathogens were detected in blood, sputum, and urine cultures. Results of further investigations were normal, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), serum rheumatoid factor (RF), angiotensin-converting enzyme (ACE), antinu-clear antibodies, antineutrophilic cytoplasmic antibodies (p and c), ELISA for human immunodeficiency virus (1 and 2), serology for syphilis (TPHA: Treponema pallidum hemagglutinin antigen, VDRL: Venereal Disease Research Laboratory), and viral hepatitis (B and C). However, because the chest X-ray revealed bilateral hilar lymphadenopathy (Figure 4A), we requested a chest CT scan to obtain a more detailed imaging of the lungs. The CT scan illustrated multiple pulmonary infiltrates consistent with pulmonary tuberculosis (Figure 4B, 4C). Therefore, although our patient was vaccinated at childhood with BCG, we performed a tuberculin skin test, and the result was strongly positive (induration diameter: 25 mm). This result, together with positive sputum cultures for Mycobacterium tuberculosis and the radiologic findings, in combination with his migration from southern India, which is regarded as an endemic area for tuberculosis, led us to a diagnosis of tuberculous uveitis; specifically, the final diagnosis was tuberculous posterior sclerouveitis, mimicking mainly VKH disease, with some features of tuberculous serpiginous-like uveitis.

View Article: PubMed Central - PubMed

ABSTRACT

Patient: male, 32"/> MedlinePlus