RESUMO
A 35-year-old lady presented with a history of decreased vision in her right eye from one week before her referral. She did not report any significant systemic disease. Ocular findings were compatible with the diagnosis of central retinal vein occlusion. Systemic laboratory tests were all within normal limits except for Mantoux test [PPD] which was positive, 18 mm induration and 2+ redness. Chest radiography was negative for lung tuberculosis. Fluorescein angiography confirmed the presence of retinal vasculitis. With a probable diagnosis of papillophlebitis secondary to tuberculosis, the patient received a course of anti-tuberculosis medications. The inflammation subsided and vision improved within a 6-months therapy. This was a rare case of presumed ocular tuberculosis with no evidence of systemic infection presenting first as a papillophlebitis
RESUMO
Brucellosis with different pictures is common in our country and should be noticed in high risk patients. A 23 years old male farmer, presented with headache, vomiting, and tremor. Disease had begun 6 months ago with right side orchitis, fever, chills, then, gradually illness, weakness, tremor, anorexia, vomiting, nonproductive cough, retrosternal pain and dysphagia, blurred vision, generalized muscular rigidity and disability in daily activities were added. In physical exam illness, weakness, fever, wet skin, tremor, generalized muscular rigidity, papillary edema were detected. He had positive Wright test [1/1250] and lymphocytic pleocytosis in CSF. Three drug regimen and steroid [1 month] were administered and he responded well to this initial therapy, however, during his 3[rd] month follow up, he developed severe bilateral hearing loss unresponsive to steroids and 6 months later he had a self-limiting 20 hours left sided hemiparesis. Neurobrucellosis may present with parkinsonism [tremor and generalized muscular rigidity] and meningovascular involvement. This may even progress under 3 antibiotic regimen treatment