Orbital tuberculosis diagnosed by immunohistochemistry: case reports Tuberculose orbitária diagnosticada por imunohistoquímica

• Published in: Revista do Instituto de Medicina Tropical de São Paulo
• Main Authors: Bráulio F.T. Oliveira, Fernanda C. Takay, Tatiana M. Shida, Ruth M. Santo, Abelardo C. Souza Jr., Suzana Matayoshi
• Format: Article in Journal/Newspaper
• Language: English
• Published: Universidade de São Paulo (USP) 2004
• Subjects: Tuberculosis; Orbit; Diagnosis; Immunochemistry; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1590/S0036-46652004000500012; https://doaj.org/article/f79a759418e346609c2b317d55e95ac6

PURPOSE: To describe three cases of orbital tuberculosis, with their clinical characteristics and respective diagnostic procedures, showing the importance of histopathology for the correct diagnosis. PATIENTS AND METHODS: Three patients diagnosed and treated for orbital tuberculosis, in the "Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo" during the years of 1999 and 2001. RESULTS: All of the patients were female and referred a chronic evolution of swelling of one eyelid associated or not with other symptoms. They had not HIV infection. Two of them had positive epidemiology for tuberculosis. However, the search for systemic evidence of the disease and staining for bacilli (Ziehl-Neelsen method) were negative in all three patients. In all the cases, only the biopsy with immunohistochemical analysis could confirm the diagnosis. COMMENTS: Orbital involvement is a rare ocular manifestation of tuberculosis. Even in a tertiary hospital, few cases, if any, are diagnosed per year. However, the global incidence and prevalence of M. tuberculosis infections is not under control yet, and it has been a serious public health problem. Thus, one must be aware of the possibility of tuberculosis among the orbital diseases. OBJETIVO: Este estudo descreve 3 casos de tuberculose orbitária, com suas características clínicas, procedimentos diagnósticos, mostrando a importância da histopatologia para o diagnóstico correto. PACIENTES E MÉTODOS: Descrição de 3 casos de pacientes com tuberculose orbitária diagnosticada e tratada no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo entre os anos 1999 e 2001 RESULTADOS: Todos os casos apresentaram-se como massa orbitária de evolução lenta e progressiva em pacientes de sexo feminino, sem doença pulmonar concomitante evidente. Duas tinham epidemiologia positiva para tuberculose. A pesquisa de bacilo álcool ácido resistente (BAAR), pelo método de Ziehl-Neelsen, entretanto, havia sido negativa em todos os casos. O diagnóstico etiológico nos ...