Multifocal choroiditis and choroidal tuberculoma: Signs of presumed ocular tuberculosis

2021 ◽  
pp. 112067212110399
Author(s):  
Marta Belmonte Grau ◽  
Muxima Acebes García ◽  
Juan Jacobo González Guijarro
Keyword(s):  
Ocular Tissues ◽  
Swept Source ◽  
Radiographic Findings ◽  
Ocular Tuberculosis ◽  
Multifocal Choroiditis ◽  
Oral Steroids ◽  
Presumed Ocular Tuberculosis ◽  
Choroidal Tuberculoma

The diagnosis of OTB (Ocular tuberculosis) is usually difficult to make. Definitive diagnosis requires the identification of M. tuberculosis organisms in ocular tissues or fluids, but samples are often difficult to obtain, and biopsy may be hard to justify. We describe a 50-years-old Maghreb male, who presented a multifocal choroiditis associated with a choroidal tuberculoma on the left eye. Based on positive QuantiFERON-TB-Gold test and suggestive clinical and radiographic findings, a diagnosis of presumed ocular tuberculosis was made. Serial swept-source optical coherence tomography (SS-OCT) and widefield fundus retinographies during subsequent follow-up visits demonstrated the characterization of the atypical tuberculosis presentation and allowed the assessment of response to antitubercular therapy and oral steroids.

Clinical features and management of presumed ocular tuberculosis: A long-term follow-up cohort study in a tertiary referral center in Brazil

2021 ◽  
pp. 112067212110446
Author(s):  
Yuslay Fernández Zamora ◽  
Luciana Peixoto Finamor ◽  
Luci Meire P Silva ◽  
Denise S Rodrigues ◽  
Ricardo P Casaroli-Marano ◽  
...  
Keyword(s):  
Clinical Features ◽  
Oral Prednisone ◽  
Interferon Gamma Release Assay ◽  
Tertiary Referral ◽  
Ocular Tuberculosis ◽  
Tertiary Referral Center ◽  
Referral Center ◽  
Significant Difference ◽  
Presumed Ocular Tuberculosis

Purpose: To evaluate the clinical features and management of presumed ocular tuberculosis (OTB). Method: A prospective 3-year follow-up study of patients with ocular inflammation that performed Interferon-gamma release assay (IGRA) and tuberculin skin test (TST) was conducted in a tertiary referral center in Brazil. Patients with clinical signs highly suspect of OTB with a positive TST and/or IGRA with other causes ruled out were prescribed anti-tuberculosis therapy (ATT) during 9 months. Clinical features and treatment outcomes were recorded. Results: Seventy-two patients (mean age 48.3 ± 15.7 years) were included in the study, and most were female (65.3%, n = 47). Posterior uveitis (43.1%, n = 31) was the main clinical feature. Multifocal choroiditis (25%, n = 18) was the most common choroidal involvement. Concomitant oral prednisone (45.8%, n = 33) during ATT was associated with more recurrences ( p = 0.04). A significant difference ( p < 0.001) between initial and final best-corrected visual acuity after ATT conclusion was observed. Cure or remission was observed in 58 (85.3%) patients that completed follow-up ( n = 68). Conclusion: In our cohort some variation in demographics and ocular phenotypes of presumed OTB was observed. The high rates of cure or remission of our patients strongly support the ATT in presumed OTB. Oral corticosteroids during ATT were associated with higher recurrences rates.

scholarly journals Unilateral choroidal tuberculoma as an initial manifestation of presumed ocular tuberculosis: a case report

2021 ◽  
Vol 80 (4) ◽  
Author(s):  
Juni Eyat Juni Ying ◽  
Chin Shi Tang ◽  
Maya Sapira Hanapi ◽  
Qi Zhe Ngoo ◽  
Wan Hazabbah Wan Hitam
Keyword(s):  
Case Report ◽  
Initial Manifestation ◽  
Ocular Tuberculosis ◽  
Presumed Ocular Tuberculosis ◽  
Choroidal Tuberculoma

Long-Term Close Follow-up of Chorioretinal Lesions in Presumed Ocular Tuberculosis

2012 ◽  
Vol 22 (2) ◽  
pp. 195-202 ◽  
Author(s):  
Mai-Anh Ducommun ◽  
Simone Eperon ◽  
Mona B. Khonkarly ◽  
Matthias Cavassini ◽  
Yan Guex-Crosier
Keyword(s):  
Ocular Tuberculosis ◽  
Presumed Ocular Tuberculosis

Follow-up of Osteomyelitis of Infants with Systemic Serum Parameters and Bone Scintigraphy

1996 ◽  
Vol 35 (04) ◽  
pp. 116-121 ◽  
Author(s):  
G. E Fueger ◽  
M. Vejda ◽  
R. M. Aigner
Keyword(s):  
Bone Scintigraphy ◽  
Antibiotic Treatment ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Laboratory Findings ◽  
Radiographic Findings ◽  
Serum Parameters ◽  
Wbc Count ◽  
Differential White Blood Cell

Summary Aim: To prevent orthopedic sequelae in acute hematogenous pyogenic osteomyelitis (AHPO) of infants early diagnosis, recognition of recurrence and effective therapy is needed. This retrospective study of 47 infants with bacteriologically confirmed AHPO concerned with an analysis of the diagnostic value of systemic serum parameters compared to bone scintigraphy (BSC). Methods: AHPO was characterized initially and during the course of disease by clinical findings, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total and differential white blood cell (WBC) count, BSC, and plain radiography. Results: CRP was the most effective serum parameter for follow- up of disease. The first sign of BSC to signal adequate response to antibiotic treatment was the decrease or normalization of hyperperfusion. Escape from therapy or poor prognosis, even when the serum parameters were normalized, was signaled by the recurrence of focal hyperperfusion and the persistent or increasing local uptake ratios on the 3-h-image over 6 weeks during a course of antibiotic treatment. Conclusion: Antibiotic treatment masks the clinical presentation, and the radiographic findings, causes non-characteristic laboratory findings, but do not prevent the scintigraphic visualization; BSC and serum parameters used in the right completion are the most successful and efficient modalities for follow-up of AHPO. Maintenance of antibiotic therapy should be done until BSC findings have reverted to normal.

Intraocular tuberculosis, a challenge in diagnosis and treatment

2020 ◽  
Vol 3 ◽  
pp. 4
Author(s):  
Martina Larroude ◽  
Gustavo Ariel Budmann
Keyword(s):  
Developing Countries ◽  
Clinical Signs ◽  
Steady Increase ◽  
Ocular Tuberculosis ◽  
Industrial Countries ◽  
Choroidal Granuloma ◽  
History Of ◽  
And Migration ◽  
Ocular Tb

Ocular tuberculosis (TB) is an extrapulmonary tuberculous condition and has variable manifestations. The incidence of TB is still high in developing countries, and a steady increase in new cases has been observed in industrial countries as a result of the growing number of immunodeficient patients and migration from developing countries. Choroidal granuloma is a rare and atypical location of TB. We present a case of a presumptive choroidal granuloma. This case exposes that diagnosis can be remarkably challenging when there is no history of pulmonary TB. The recognition of clinical signs of ocular TB is extremely important since it provides a clinical pathway toward tailored investigations and decision making for initiating anti-TB therapy and to ensure a close follow-up to detect the development of any complication.

scholarly journals A closed-loop optogenetic screen for neurons controlling feeding in Drosophila

2021 ◽  
Author(s):  
Celia K S Lau ◽  
Meghan Jelen ◽  
Michael D Gordon
Keyword(s):  
Drosophila Melanogaster ◽  
Expression Pattern ◽  
Sensory Neurons ◽  
Closed Loop ◽  
Higher Order ◽  
Taste Detection ◽  
Proof Of Principle ◽  
Feeding Circuits

Abstract Feeding is an essential part of animal life that is greatly impacted by the sense of taste. Although the characterization of taste-detection at the periphery has been extensive, higher order taste and feeding circuits are still being elucidated. Here, we use an automated closed-loop optogenetic activation screen to detect novel taste and feeding neurons in Drosophila melanogaster. Out of 122 Janelia FlyLight Project GAL4 lines preselected based on expression pattern, we identify six lines that acutely promote feeding and 35 lines that inhibit it. As proof of principle, we follow up on R70C07-GAL4, which labels neurons that strongly inhibit feeding. Using split-GAL4 lines to isolate subsets of the R70C07-GAL4 population, we find both appetitive and aversive neurons. Furthermore, we show that R70C07-GAL4 labels putative second-order taste interneurons that contact both sweet and bitter sensory neurons. These results serve as a resource for further functional dissection of fly feeding circuits.

scholarly journals Proteinuria in COVID-19: prevalence, characterization and prognostic role

2021 ◽  
Author(s):  
Justine Huart ◽  
Antoine Bouquegneau ◽  
Laurence Lutteri ◽  
Pauline Erpicum ◽  
Stéphanie Grosch ◽  
...  
Keyword(s):  
Urinary Catheter ◽  
Single Center ◽  
Tubular Injury ◽  
Tubular Proteinuria ◽  
Prognostic Role ◽  
Urine Creatinine ◽  
Single Center Study ◽  
Center Study

Abstract Background Proteinuria has been commonly reported in patients with COVID-19. However, only dipstick tests have been frequently used thus far. Here, the quantification and characterization of proteinuria were investigated and their association with mortality was assessed. Methods This retrospective, observational, single center study included 153 patients, hospitalized with COVID-19 between March 28th and April 30th, 2020, in whom total proteinuria and urinary α1-microglobulin (a marker of tubular injury) were measured. Association with mortality was evaluated, with a follow-up until May 7th, 2020. Results According to the Kidney Disease Improving Global Outcomes staging, 14% (n = 21) of the patients had category 1 proteinuria (< 150 mg/g of urine creatinine), 42% (n = 64) had category 2 (between 150 and 500 mg/g) and 44% (n = 68) had category 3 proteinuria (over 500 mg/g). Urine α1-microglobulin concentration was higher than 15 mg/g in 89% of patients. After a median follow-up of 27 [14;30] days, the mortality rate reached 18%. Total proteinuria and urinary α1-microglobulin were associated with mortality in unadjusted and adjusted models. This association was stronger in subgroups of patients with normal renal function and without a urinary catheter. Conclusions Proteinuria is frequent in patients with COVID-19. Its characterization suggests a tubular origin, with increased urinary α1-microglobulin. Tubular proteinuria was associated with mortality in COVID-19 in our restropective, observational study.

scholarly journals Risk Factors for Failure in Conservatively Treated Osteoporotic Vertebral Fractures: A Systematic Review

2021 ◽  
pp. 219256822098227
Author(s):  
Max J. Scheyerer ◽  
Ulrich J. A. Spiegl ◽  
Sebastian Grueninger ◽  
Frank Hartmann ◽  
Sebastian Katscher ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Treatment Failure ◽  
Patient Specific ◽  
Mineral Density ◽  
Radiographic Findings ◽  
Specific Risk ◽  
Fracture Development ◽  
Predict Treatment Failure

Study Design: Systematic review. Objectives: Osteoporosis is one of the most common diseases of the elderly, whereby vertebral body fractures are in many cases the first manifestation. Even today, the consequences for patients are underestimated. Therefore, early identification of therapy failures is essential. In this context, the aim of the present systematic review was to evaluate the current literature with respect to clinical and radiographic findings that might predict treatment failure. Methods: We conducted a comprehensive, systematic review of the literature according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) checklist and algorithm. Results: After the literature search, 724 potentially eligible investigations were identified. In total, 24 studies with 3044 participants and a mean follow-up of 11 months (range 6-27.5 months) were included. Patient-specific risk factors were age >73 years, bone mineral density with a t-score <−2.95, BMI >23 and a modified frailty index >2.5. The following radiological and fracture-specific risk factors could be identified: involvement of the posterior wall, initial height loss, midportion type fracture, development of an intravertebral cleft, fracture at the thoracolumbar junction, fracture involvement of both endplates, different morphological types of fractures, and specific MRI findings. Further, a correlation between sagittal spinal imbalance and treatment failure could be demonstrated. Conclusion: In conclusion, this systematic review identified various factors that predict treatment failure in conservatively treated osteoporotic fractures. In these cases, additional treatment options and surgical treatment strategies should be considered in addition to follow-up examinations.

scholarly journals Clinical and Radiographic Findings of Septic Physitis in Foals

VCOT Open ◽  
2020 ◽  
Vol 03 (02) ◽  
pp. e134-e139
Author(s):  
David G. Suarez-Fuentes ◽  
Dane M. Tatarniuk
Keyword(s):  
Medical Records ◽  
Radiographic Feature ◽  
Radiographic Findings ◽  
Radiographic Features

AbstractThe objective of this review is to detail the clinical and radiographic features of septic physitis in foals. Medical records were evaluated from 2008 to 2018 of cases that had septic physitis based on a combination of clinical and radiographic findings. Ten foals were diagnosed with septic physitis. In 8 of 10 foals, presence of a discrete, focal, irregular radiolucency centred on the physis and extending into the epiphysis and metaphysis was present. In the remaining two foals, subtle irregularity and diffuse radiolucency along the length of the physis was present. Three foals were able to later perform athletic function and two were sound but not in training (mean follow-up = 12 months). Overall, a distinguishing radiographic feature of septic physitis in foals is the presence of a focal radiolucency centred on the physis which is associated with the epiphysis and metaphysis consistent with osteolysis.

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