rifampin and Blindness

Intracranial tuberculomas are rare yet lethal forms of tuberculosis. Diagnosis is often difficult because of its nonspecific symptoms and radiological findings.. This study aims to perform a literature review of multiple tuberculomas to improve disease recognition and management in immunocompetent patients along with presenting a case report on the topic.. Scopus, LILACS, Ovid MEDLINE and EMBASE.. Case reports and case series up to December 2018 in English, Spanish, and Portuguese focusing on intracranial tuberculomas in adult and pediatric immunocompetent patients. Data on presentation, diagnostic workup, and treatment was analyzed.. Cochrane Collaboration/Cochrane Handbook and PRISMA guidelines.. Twenty reports involving 21 patients were included. Most patients were male (57.14%). The average age at diagnosis was 26.9 ± 14.9 years. Headache was the most common presenting symptom (52.4%; 11/21), followed by motor weakness (47.6%; 10/21) and vomiting (23.8%; 5/21). MRI was the most used image technique (17/21). Most lesions occurring in the cerebral hemispheres (16/21); we found five or more lesions in 66.6% (14/21) of the patients. The majority treated with anti-tuberculous drugs resulted in a favorable outcome.. Immunocompetent patients living in TB endemic areas whose clinical evaluation and neuroimaging findings are compatible with tuberculoma should undergo anti-tubercular treatment despite a lack of bacteriological confirmation.

Topics: Antitubercular Agents; Blindness; Brain; Brain Diseases; Cerebellar Ataxia; Dexamethasone; Drug Therapy, Combination; Endemic Diseases; Ethambutol; Female; Glucocorticoids; Humans; Immunocompetence; Isoniazid; Magnetic Resonance Imaging; Nausea; Nystagmus, Pathologic; Peru; Pyrazinamide; Quadriplegia; Rifampin; Tomography, X-Ray Computed; Tuberculoma, Intracranial; Tuberculosis, Pulmonary; Vomiting; Young Adult

To report atypical clinical features of Bartonella henselae neuroretinitis treated with combination antibiotics.. Case report.. A 20-year-old man with a positive B. henselae titer developed a unilateral neuroretinitis, a large peripapillary angiomatous lesion, branch artery occlusion with ischemic maculopathy, and vision loss that failed to improve with clindamycin. Treatment with doxycycline and rifampin led to rapid clinical improvement. The severe vision loss in this case is atypical.. Ocular findings associated with B. henselae infection may include retinal angiomatous lesion and branch retinal artery occlusion. Doxycycline and rifampin were successful in treating the infection.

Topics: Adult; Antibodies, Bacterial; Bartonella henselae; Blindness; Cat-Scratch Disease; Doxycycline; Drug Therapy, Combination; Enzyme-Linked Immunosorbent Assay; Eye Infections, Bacterial; Fluorescein Angiography; Fundus Oculi; Hemangioma, Capillary; Humans; Male; Optic Neuritis; Retinal Artery Occlusion; Retinal Neoplasms; Retinal Vessels; Retinitis; Rifampin; Visual Acuity

Of the 20 patients given rifampicin and isoniazid, 19 survived and one died. Twelve patients recovered from the disease without any significant neurologic defect. Seven patients had moderate to severe handicaps which included hemiparesis in four, hydrocephalus in two,mental retardation in three, and blindness in one. There was no hearing deficit. The average hospital stay in this group was 3-1/2 weeks. Among the 13 patients given streptomycin, PAS, and isoniazid, four are dead. Only three patients recovered with a completely good condition. The remainder had either single or multiple neurologic defects. The moderate degree of nerve deafness was also observed in two patients.

Topics: Adolescent; Aminosalicylic Acids; Blindness; Child; Child, Preschool; Drug Evaluation; Drug Therapy, Combination; Hemiplegia; Humans; Hydrocephalus; Infant; Infant, Newborn; Intellectual Disability; Isoniazid; Rifampin; Tuberculosis, Meningeal

Topics: Adult; Blindness; Conjunctiva; Cornea; Eye Manifestations; Female; Fundus Oculi; Humans; Inflammation; Injections; Leprosy; Malaysia; Male; Middle Aged; Racial Groups; Rifampin; Sclera; Sex Factors; Sulfones; Uvea