Bilateral Primary Optic Neuropathy as the presenting manifestation of Tuberculosis in an immunocompetent patient

Publication date: Available online 11 July 2019Source: IDCasesAuthor(s): Santhosh Narayanan, Divya Prakash, Gomathy SubramaniamAbstractVision impairment is one of the devastating complications of central nervous system tuberculosis (CNS TB). Optic atrophy is a sequelae of various forms of CNS TB which, ultimately, is responsible for vision impairment. It is usually the secondary optic atrophy which occurs in CNS TB. In this case report, we present the story of an immunocompetent woman presenting as bilateral visual loss. She was found to have primary optic atrophy. Neuroimaging revealed features of chronic meningitis. Polymerase chain reaction test for Mycobacterium tuberculosis was positive in cerebrospinal fluid. Although secondary optic atrophy is common in the CNS TB, as a complication of meningitis, primary optic atrophy per se is infrequently reported.
Source: IDCases - Category: Infectious Diseases Source Type: research

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Purpose of review Describe the range of infectious causes of ocular motor neuropathies, from common presentations to unusual manifestations of diseases less frequently seen in the developed world. Provide information on recent developments in diagnostic testing for pathogens that may cause ocular motor neuropathies. Recent findings Antigen detection in serum or CSF has improved the diagnosis of cryptococcal disease. Cartridge PCR testing for tuberculosis has increased diagnostic accuracy, though tuberculous meningitis remains difficult to diagnose. Rapid, multiplex PCR and unbiased sequencing allow for diagnosis of a ...
Source: Current Opinion in Ophthalmology - Category: Opthalmology Tags: NEURO-OPHTHALMOLOGY: Edited by Dean M. Cestari Source Type: research
In this study, we report a new method for detecting cell-free Mycobacterium tuberculosis DNA (cf-TB) in CSF and evaluate its clinical value for TBM diagnosis. METHODS: Of 68 patients prospectively recruited, 46 were diagnosed as having TBM and 22 as non-TBM. We compared the cf-TB method with CSF smear microscopy, mycobacterial culture, and the Xpert MTB/RIF assay (Xpert) using the consensus case definition for TBM proposed in 2009 as a reference standard. RESULTS: The sensitivity of the cf-TB test was 56.5% (26/46) in patients with TBM, and it was significantly higher than other methods: microscopy (2.2%, 1/46; P
Source: American Journal of Clinical Pathology - Category: Pathology Authors: Tags: Am J Clin Pathol Source Type: research
Muscular hypotonia is considered as one of the rarest forms of initial onset signs of TBM, in addition to aphasia and hyponatremia, the awareness of those rare onset signs, a well ‐conducted diagnostic approach and early treatment can improve the outcome. AbstractMuscular hypotonia is considered as one of the rarest forms of initial onset signs of TBM, in addition to aphasia and hyponatremia, the awareness of those rare onset signs, a well ‐conducted diagnostic approach and early treatment can improve the outcome.
Source: Clinical Case Reports - Category: General Medicine Authors: Tags: CASE REPORT Source Type: research
Semin Neurol 2019; 39: 482-494 DOI: 10.1055/s-0039-1687915Central nervous system (CNS) infections are a frequently underappreciated potential etiology of cerebrovascular disease. Highlighted in this review are a selection of infectious agents that lead to cerebrovascular complications through various mechanisms including multifocal vasculopathy, focal infiltrative vasculitis and vasospasm, and direct vessel wall invasion and thrombus formation. Diagnosis of stroke due to underlying CNS infection requires a high index of clinical suspicion and careful consideration of neuroimaging, serum, and cerebrospinal fluid studies in ...
Source: Seminars in Neurology - Category: Neurology Authors: Tags: Review Article Source Type: research
We describe demographic, socioeconomic and clinical characteristics of patients randomized to the same-day initiation arm for both studies. RESULTS AND DISCUSSION: A total of 240 and 296 participants were enrolled in Kenya and South Africa. The majority were female (59% and 64% respectively), with a median age of 35 years. In both countries, most subjects were newly diagnosed with HIV on the day of enrolment (62%, 55%), believed they already had adequate knowledge to begin ART (78%, 68%), and preferred to start ART immediately (same-day) (98% in both countries). About 40% of all patients had at least one symptom r...
Source: Journal of the International AIDS Society - Category: Infectious Diseases Tags: J Int AIDS Soc Source Type: research
CONCLUSIONS: Diagnosis of EPTB and PTB at ART programmes in LMIC was mainly based on clinical criteria. Greater availability and usage of TB diagnostic tests would improve the diagnosis and clinical outcomes of both EPTB and PTB. PMID: 31507083 [PubMed - in process]
Source: Journal of the International AIDS Society - Category: Infectious Diseases Tags: J Int AIDS Soc Source Type: research
Conclusion: Aspirin reduces the risk of new infarctions in patients with tuberculous meningitis but does not affect mortality (moderate-to-low level of evidence).
Source: Neurology India - Category: Neurology Authors: Source Type: research
Tuberculous meningitis (TBM) is the most common and severe form of central nervous system tuberculosis. Due to the non-specific clinical presentation and lack of efficient diagnosis methods, it is difficult to discriminate TBM from other frequent types of meningitis, especially viral meningitis (VM). In order to identify the potential biomarkers for discriminating TBM and VM and to reveal the different pathophysiological processes between TBM and VM, a genome-wide miRNA screening of PBMCs from TBM, VM, and healthy controls (HCs) using microarray assay was performed (12 samples). Twenty-eight differentially expressed miRNAs...
Source: Frontiers in cellular and infection microbiology - Category: Microbiology Source Type: research
Conclusions: Our study indicates that mNGS is an alternative method to detect the presence of mycobacterial DNA in CSF samples from patients with TBM and deserves to apply as a front-line CSF test.
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
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Source: AuntMinnie.com Headlines - Category: Radiology Source Type: news
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