결핵에 의한 시신경교차 거미막염

Tuberculous optochiasmatic arachnoiditis (OCA) is a rare complication of tuberculous meningitis. We describe a 47-year-old female with tuberculous OCA confused with ethambutol-associated optic neuropathy. She was on anti-tuberculous treatment (i.e., isoniazid, rifampin, ethambutol, and pyrazinamide)...

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Bibliographic Details
Published inThe Korean journal of medicine Vol. 82; no. 5; pp. 642 - 646
Main Authors 박소은, So Eun Park, 김지범, Ji Beom Kim, 강보형, Bo Hyoung Kang, 안지현, Ji Hyun An, 김유재, You Jae Kim, 임현택, Hyun Taek Lim, 김성한, Sung Han Kim
Format Journal Article
LanguageKorean
Published 대한내과학회 01.05.2012
Subjects
Arachnoiditis
Ethambutol
Impaired vision
Optic chiasm
Tuberculous meningitis
결핵성 수막염
시각 장애
시신경교차 거미막염
에탐부톨 시신경 독성
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Summary:Tuberculous optochiasmatic arachnoiditis (OCA) is a rare complication of tuberculous meningitis. We describe a 47-year-old female with tuberculous OCA confused with ethambutol-associated optic neuropathy. She was on anti-tuberculous treatment (i.e., isoniazid, rifampin, ethambutol, and pyrazinamide) for two months due to tuberculous meningitis. Visual impairment occurred during treatment, and ethambutol was changed to levofloxacin because of concern for ethambutol-associated optic neuropathy. Her visual impairment did not improve three months after anti-tuberculous treatment that excluded ethambutol, and she was referred to our hospital. Brain MRI showed enhancement of the optic chiasm and bilateral optic tract, and fundoscopy revealed bilateral optic nerve atrophy, suggesting tuberculous OCA. Her visual acuity was partially improved after anti-tuberculous treatment. Tuberculous OCA should be considered in addition to ethambutol-associated optic neuropathy for a patient with tuberculous meningitis who presents with visual impairment. (Korean J Med 2012;82:642-646)
Bibliography:The Korean Association Of Internal Medicine
ISSN:1738-9364