PAPILLEDEMA SECONDARY TO CEREBRAL TUBERCULOSIS: CASE REPORT AND LITERATURE REVIEW.
To report a case and discuss the topics
Analysis of medical records from João Penido Burnier`s Foundation and literatura review. Patient 37 year-old - woman was referred to our center with headache, diplopia , dizziness and divergent strabismus in right eye for 30 days. Ophthalmic examination revealed anisocoria with right eye miosis and exotropia. Brain magnetic resonance imaging revealed a granulomatous process in the right pontine cistern. Thoracic tomography revealed a calcified pulmonary nodule. Patient underwent to Sarcoidosis and Tuberculosis screening as negative BAAR test and normal dosage angiotensin converting enzyme. Progressed with the and increased cerebrospinal fluid pressure and papilledema.
The patient received treatment for cerebral tuberculosis with Ethambutol, Pyrimethamine, Isoniazid and Rifampicin and progressed with improvement of papilledema and other symptoms
Tuberculosos can affect all eye tissues and causes choroiditis, uveitis, scleritis, corneal ulcer and optic neuritis. The tuberculin test is of limited value for diagnosis. In the case report, we observed papilledema and paresis of the sixth cranial nerve secondary to cranial hypertension due to the formation of granuloma in the pontine cistern. Despite the negative tuberculin tests, the patient was submitted to treatment for neural Tuberculosis and evolved with improvement of the condition. Therefore the ophthalmic signs and symptoms were paramount for diagnosis.
Tuberculosis; Papilledema;
CLINICAL RETINA
Fundação Dr. João Penido Burnier - São Paulo - Brasil
Paulo Dechichi Netto, Jessica Araujo Sousa, Renata Nakamura Silva, Fernanda Nonato Federici, Rafael Nojiri Moreira, Tiago Almeida Carvalho, Vinicius Clementino Falcão, Gustavo Goncalves de Paula Mortari