RESUMEN
Whipple's disease is a multisystem bacterial disease usually characterized by malabsorption, diarrhea and polyarthritis. Ocular manifestations include uveitis, vitreitis, retinis, myositis, papilledema and optic atrophy. We report a case of a chronic bilateral vitreitis in a 63 year-old man who had been treated for a Whipple's disease with gastrointestinal involvement 30 years before. The jejunal biopsy was negative but the polymerase-chain-reaction (PCR) revealed the presence of Trophyrema Whippelii in the vitreous prelevement of both eye. This new, original strategy of PCR is specific and more sensitive than histological diagnosis.
Asunto(s)
Actinomyces/aislamiento & purificación , Reacción en Cadena de la Polimerasa , Uveítis/diagnóstico , Cuerpo Vítreo/microbiología , Enfermedad de Whipple/diagnóstico , Actinomyces/genética , Biopsia , Diagnóstico Diferencial , Humanos , Yeyuno/patología , Masculino , Persona de Mediana Edad , ARN Ribosómico 16S/genética , Uveítis/microbiología , Enfermedad de Whipple/microbiologíaRESUMEN
We report a case of a 31 year-old man who presented a bilateral ischemic optic neuropathy associated with headaches and severe systemic hypertension. This episode appeared after administration of ergotamine tartrate and macrolides. This medication probably led to a vasospasm which occurs in patients with hypertension. The cardiovascular and serum lipid evaluations were normal. A migraine optic neuropathy can be evoked.