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1.
Ann Thorac Surg ; 109(2): e109-e111, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31301274

RESUMO

A patient with main pulmonary artery mass may have severe symptoms and warrants urgent surgical management, whereas in a stable patient with a diagnosis amenable to medical treatment, medical management should be started while monitoring the size of the lesion. We report a case in which the patient experienced severe right heart dysfunction due to obstruction of the main pulmonary artery, diagnosed as a probable thrombus, and the patient was taken for urgent surgical excision, later diagnosed as tuberculoma on histopathologic examination.


Assuntos
Artéria Pulmonar/diagnóstico por imagem , Estenose de Artéria Pulmonar/etiologia , Tuberculoma/complicações , Tuberculose Cardiovascular/complicações , Procedimentos Cirúrgicos Vasculares/métodos , Adolescente , Diagnóstico Diferencial , Ecocardiografia , Humanos , Masculino , Artéria Pulmonar/cirurgia , Estenose de Artéria Pulmonar/diagnóstico , Estenose de Artéria Pulmonar/cirurgia , Tuberculoma/diagnóstico , Tuberculoma/cirurgia , Tuberculose Cardiovascular/diagnóstico , Tuberculose Cardiovascular/cirurgia
3.
Chest ; 156(2): e51-e55, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31395269

RESUMO

CASE PRESENTATION: A 22-year-old woman was admitted to our department for fever of unknown origin. The patient reported intermittent fever and nonspecific abdominal pain for several years. Six months before admission she started complaining of palpitations and exertional dyspnea. She had no weight loss, chest pain, headache, or joint complaints. Medical history was unremarkable. She did not consume tobacco, alcohol, or illicit drugs. The patient was from Malia. She had lived in France for 4 years and did not report recent travel.


Assuntos
Arritmias Cardíacas/etiologia , Febre/etiologia , Pericardite Tuberculosa/diagnóstico , Tuberculoma/diagnóstico , Arritmias Cardíacas/diagnóstico por imagem , Feminino , Febre/diagnóstico por imagem , França , Humanos , Imagem por Ressonância Magnética , Pericardite Tuberculosa/complicações , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Tuberculoma/complicações , Adulto Jovem
4.
Saudi J Kidney Dis Transpl ; 29(3): 719-722, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29970752

RESUMO

A paradoxical reaction during anti-tuberculosis (anti-TB) therapy is commonly reported in patients with human immunodeficiency virus (HIV). However, a similar reaction to anti-TB therapy can also occur in patients without HIV, especially in patients who have undergone solid organ transplantation. A 65-year-old woman who underwent kidney transplantation six months prior presented to our emergency room with progressive paraparesis. She had been diagnosed with drug-susceptible miliary TB and had undergone two weeks of treatment with anti-TB medication. Magnetic resonance imaging showed a spinal intramedullary mass and multiple intracranial nodules. The etiology of the lesions was confirmed as Mycobacterium tuberculosis. We report a paradoxical reaction of spinal intramedullary and multiple intracranial tuberculomas in a patient with miliary TB who had received appropriate treatment for more than two weeks.


Assuntos
Transplante de Rim/efeitos adversos , Tuberculoma , Tuberculose do Sistema Nervoso Central , Idoso , Antituberculosos/uso terapêutico , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Feminino , Humanos , Imagem por Ressonância Magnética , Radiografia Torácica , Coluna Vertebral/diagnóstico por imagem , Coluna Vertebral/patologia , Tuberculoma/complicações , Tuberculoma/diagnóstico por imagem , Tuberculoma/tratamento farmacológico , Tuberculose do Sistema Nervoso Central/complicações , Tuberculose do Sistema Nervoso Central/diagnóstico por imagem , Tuberculose do Sistema Nervoso Central/tratamento farmacológico , Tuberculose Miliar/complicações , Tuberculose Miliar/tratamento farmacológico
5.
J Coll Physicians Surg Pak ; 28(6): S97-S98, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29866234

RESUMO

Tuberculosis rarely involves the hypothalamo-pituitary region and constitutes only 1% of the lesions involving the sellar and/or suprasellar region. Coleman and Meredith first reported pituitary tuberculosis in 1940, and only a handful of cases have been reported ever since. It may manifest as a chiasmal syndrome due to compression of the optic chiasm or as hypopituitarism due to pituitary destruction. It has a characteristic radiological appearance and can mimic a pituitary adenoma. Diagnostic procedures, such as trans-sphenoidal biopsy, are crucial for accurate diagnosis. We report a case of a 32-year male, who presented with complaints of headache and decreased visual acuity for the past 6 months. Eye examination revealed bitemporal hemianopsia. Brain MRI scan showed a mass in the sella with features suggestive of pituitary adenoma. Transcranial resection of the mass was performed; histopathology of the excised mass proved it to be a pituitary tuberculoma.


Assuntos
Cefaleia/etiologia , Hipopituitarismo/etiologia , Imagem por Ressonância Magnética/métodos , Quiasma Óptico/diagnóstico por imagem , Doenças da Hipófise/diagnóstico por imagem , Hipófise/diagnóstico por imagem , Tuberculoma/diagnóstico por imagem , Adulto , Antituberculosos/uso terapêutico , Craniotomia , Terapia de Reposição Hormonal , Humanos , Hipopituitarismo/terapia , Masculino , Quiasma Óptico/irrigação sanguínea , Doenças da Hipófise/complicações , Hipófise/cirurgia , Tuberculoma/complicações , Tuberculoma/tratamento farmacológico , Tuberculoma/cirurgia , Transtornos da Visão/etiologia
9.
Ocul Immunol Inflamm ; 26(2): 239-241, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-27541084

RESUMO

The authors present a 36-year-old female with pulmonary tuberculosis who developed a choroidal tuberculoma in the left eye. The choroidal tuberculoma successfully resolved with visual gain following oral anti-tubercular and oral steroid therapy leaving behind a chorioretinal scar. One year after the completion of anti-tubercular treatment, she developed visual loss due to the development of a secondary choroidal neovascular membrane at the fovea. This was treated successfully with one intravitreal injection of bevacizumab in the left eye. The fovea remained free of fluid until the last follow-up 10 months after the intravitreal injection. Intravitreal bevacizumab may be an effective modality for treating secondary choroidal neovascular membranes that may form at the edge of a healed choroidal tuberculoma.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Bevacizumab/uso terapêutico , Neovascularização de Coroide/tratamento farmacológico , Tuberculoma/complicações , Tuberculose Ocular/complicações , Adulto , Neovascularização de Coroide/diagnóstico por imagem , Neovascularização de Coroide/etiologia , Neovascularização de Coroide/fisiopatologia , Feminino , Humanos , Injeções Intravítreas , Líquido Sub-Retiniano , Tomografia de Coerência Óptica , Tuberculoma/diagnóstico por imagem , Tuberculose Ocular/diagnóstico por imagem , Tuberculose Pulmonar/complicações , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual/fisiologia
11.
Ethiop J Health Sci ; 27(6): 677-680, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29487477

RESUMO

Background: Pediatric nervous system tuberculomas are usually infra-tentorial and multiple. A frontal lobe location is rare. Case Details: We report a 10 year-old boy who presented with a chronic headache and episodes of loss of consciousness. He had no signs of primary pulmonary tuberculosis and a diagnosis of frontal tuberculoma was made upon a post-operative biopsy. He improved following treatment with anti-tubercular drugs. Conclusion: Tuberculosis should be considered in children with a chronic headache or focal neurologic deficit and a supra-tentorial intracranial mass in endemic countries like Ethiopia.


Assuntos
Lobo Frontal/patologia , Cefaleia/diagnóstico , Síncope/diagnóstico , Tuberculoma/diagnóstico , Antituberculosos/uso terapêutico , Biópsia , Criança , Cefaleia/etiologia , Humanos , Masculino , Síncope/etiologia , Tuberculoma/complicações , Tuberculoma/tratamento farmacológico , Tuberculoma/cirurgia
12.
Zhonghua Jie He He Hu Xi Za Zhi ; 39(9): 719-22, 2016 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-27600423

RESUMO

OBJECTIVE: To study the MRI features of ventricular system tuberculosis. METHODS: Nineteen patients with ventricular system tuberculosis in our hospital from Mar. 2009 to Sep. 2014 were retrospectively identified. Their clinical features and cranial MRI characteristics were reviewed. RESULTS: There were 13 males and 6 females, aged from 15-81 years(mean 37±16). Eight patients had intraventricular tuberculosis, with 5 long striped or irregular shaped intraventricular tuberculosis and 3 with ventricular tuberculoma. Six patients had tubercular ependymitis and 5 had intraventricular tuberculosis along with tubercular ependymitis. The lesions of 14 patients were in the lateral ventricle; 13 in occipital or temporal horn of lateral ventricle, 9 complicated by tubercular meningitis, and 10 complicated by brain tuberculoma. The lesion of 5 patients were in the fourth ventricle, 5 in the postmedian of the fourth ventricle, 5 complicated by tubercular meningitis and 4 complicated by hydrocephalus. There were 4 cases with ring-enhancement and 15 with heterogeneous enhancement. Ten cases were complicated by peripheral edema. CONCLUSIONS: The diagnosis of ventricle system tuberculosis is difficult due to its low incidence. The site, cranial MRI characteristics, the patterns of enhancement and complications have certain specificity and are useful in the diagnosis of ventricular system tuberculosis.


Assuntos
Ventrículos Cerebrais/diagnóstico por imagem , Ventriculite Cerebral/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Tuberculoma Intracraniano/diagnóstico por imagem , Tuberculoma/complicações , Tuberculose do Sistema Nervoso Central/diagnóstico por imagem , Tuberculose Meníngea/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
13.
No Shinkei Geka ; 44(8): 679-84, 2016 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-27506845

RESUMO

We herein report a surgical case of multiple cerebral calculi located within the chiasmatic cistern resulting in visual disturbance. A 61-year-old man experienced homonymous lower right quadrantanopsia a few years prior. Non-enhanced head CT revealed multiple calcified lesions of about 7-mm within the basal cistern. MRI showed the lesion compressing the left optic tract. We could not remove the entire lesion because of severe adhesion to the optic tract. A pathological test showed calcified lesions with lymphocyte infiltration. We diagnosed tuberculoma caused by tuberculous meningitis with degeneration of the calcified lesion because of a history of tuberculosis at a fetal age. After the surgery, the patient was discharged without improvement of the visual disturbance.


Assuntos
Tuberculoma/cirurgia , Transtornos da Visão/etiologia , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Imagem Multimodal , Tomografia Computadorizada por Raios X , Tuberculoma/complicações , Tuberculoma/diagnóstico por imagem
14.
World Neurosurg ; 89: 726.e1-4, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26805697

RESUMO

BACKGROUND: Intramedullary spinal tuberculoma combined with abscess has low incidence and could easily be misdiagnosed. Given the rarity of spinal intramedullary tuberculoma, there is no standardized treatment protocol for this condition. We reported the case of a 28-year-old male who was diagnosed with intramedullary tuberculoma combined with abscess and treated with antituberculosis therapy followed by surgery. CASE DESCRIPTION: A 28-year-old male was admitted to our hospital with lower back pain and lower limb sensory and motor dysfunction. The radiographic results indicated tuberculosis (TB). The patient was suggested to undergo anti-TB therapy and was later transferred to Tuberculosis Hospital for systemic treatment for 20 days. He was readmitted to our hospital because of aggravating syndromes including impaired superficial sensation below the T11 level, spastic paresis with muscle strength of 0/5 in both lower extremities, and exaggerated bilateral tendon reflexes. To alleviate the neurologic dysfunction, surgery was undertaken. The postoperative diagnosis was thoracic intramedullary TB combined with abscess. He reported marked improvement in lower limb motor and sensory function the day after surgery, and his muscle strength recovered to 3/5. CONCLUSIONS: Although intramedullary TB combined with abscess is clinically rare, it should be taken into consideration when patients present with intramedullary space-occupying lesions with TB lesions elsewhere. Most patients respond well to the anti-TB therapy, but for those with severe spinal cord compression or those irresponsive to the drug therapy, surgical intervention could facilitate neurologic recovery and improve the prognosis.


Assuntos
Abscesso/complicações , Tuberculoma/complicações , Tuberculoma/patologia , Abscesso/cirurgia , Adulto , Humanos , Imagem por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X , Tuberculoma/cirurgia
18.
Intern Med ; 54(10): 1247-51, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25986265

RESUMO

A 50-year-old woman presented with a headache and nausea. A sellar and suprasellar mass was detected on MRI; the tumor was heterogeneously enhanced with gadolinium, and the pituitary stalk was slightly thickened. Laboratory tests revealed severe growth hormone, luteinizing hormone, follicle-stimulating hormone and thyroid-stimulating hormone deficiencies. A pathological examination of the tumor showed scattered granulomas with central necrosis and Langhans giant cells. Tuberculin skin and QuantiFERON TB-Gold tests (QFT-2G) were positive. Accordingly, we diagnosed the patient with pituitary tuberculoma presenting with pituitary dysfunction. Following treatment with antituberculous drugs, the pituitary hormone function normalized and the pituitary tuberculoma disappeared.


Assuntos
Hipopituitarismo/etiologia , Doenças da Hipófise/complicações , Doenças da Hipófise/patologia , Tuberculoma/complicações , Tuberculoma/patologia , Antituberculosos/uso terapêutico , Feminino , Hormônio Foliculoestimulante/fisiologia , Humanos , Hormônio Luteinizante/fisiologia , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Hipófise/patologia , Tuberculoma/tratamento farmacológico
19.
BMC Anesthesiol ; 14: 100, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25414594

RESUMO

BACKGROUND: Paraplegia associated with epidural anesthesia or caused by intramedullary spinal tuberculoma is rare but catastrophic. We present a case of paraplegia following epidural anesthesia in a patient with an undiagnosed intramedullary spinal tuberculoma. CASE PRESENTATION: A 42-year-old man developed paraplegia after an open cholecystectomy under epidural anesthesia. Spinal cord infarction, acute transverse myelitis, and intramedullary neoplasms were ruled out by histopathologic examination, and intramedullary spinal tuberculoma at the T6-T7 level was identified. Despite surgical treatment and subsequent antituberculous therapy, the patient retained some disability attributable to the delay in diagnosis. CONCLUSION: Physicians should be aware of coexisting disease as a cause of paraplegia following procedures using epidural anesthesia. Magnetic resonance imaging is the most sensitive diagnostic test, although it is still difficult to differentiate spinal cord infarction, myelitis, intramedullary spinal tuberculoma, and neoplasms from imaging features alone.


Assuntos
Anestesia Epidural/efeitos adversos , Paraplegia/etiologia , Tuberculoma/patologia , Tuberculose da Coluna Vertebral/patologia , Adulto , Anestesia Epidural/métodos , Antituberculosos/uso terapêutico , Colecistectomia/métodos , Diagnóstico Tardio , Humanos , Imagem por Ressonância Magnética , Masculino , Tuberculoma/complicações , Tuberculoma/diagnóstico , Tuberculose da Coluna Vertebral/complicações , Tuberculose da Coluna Vertebral/etiologia
20.
Intern Med ; 53(15): 1669-74, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25088884

RESUMO

We herein report a clinical pitfall regarding the treatment of a case of pulmonary tuberculoma in a patient with chronic hepatitis C. The patient presented with both chronic hepatitis C and pulmonary tuberculoma, and we initiated treatment of the chronic hepatitis C first due to the potential for liver injury; however, the patient's condition worsened in terms of the pulmonary tuberculosis. This case highlights the need to select the initial treatment for pulmonary tuberculoma, not chronic hepatitis C. In addition, we report that, although the administration of anti-tuberculosis chemotherapy regimens containing pyrazinamide (PZA) substantially increases the incidence of drug-induced hepatitis in patients with chronic hepatitis, we were fortunately able to use PZA without observing drug-induced hepatitis in this case because we closely monitored the patient's liver function.


Assuntos
Antituberculosos/uso terapêutico , Antivirais/uso terapêutico , Hepatite C Crônica/tratamento farmacológico , Tuberculoma/tratamento farmacológico , Tuberculose Pulmonar/tratamento farmacológico , DNA Viral/análise , Quimioterapia Combinada , Feminino , Seguimentos , Hepacivirus/genética , Hepatite C Crônica/complicações , Humanos , Biópsia Guiada por Imagem , Isoniazida/uso terapêutico , Pulmão/diagnóstico por imagem , Pulmão/microbiologia , Pulmão/patologia , Pessoa de Meia-Idade , Mycobacterium tuberculosis/isolamento & purificação , Guias de Prática Clínica como Assunto , Pirazinamida/uso terapêutico , Rifampina/uso terapêutico , Tomografia Computadorizada por Raios X , Tuberculoma/complicações , Tuberculoma/diagnóstico , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/diagnóstico
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