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Images in Clinical Practice

Indian Pediatrics 2004; 41:1167

Choroid Tubercles


An 11-year-old female presented with fever for 3½ months, headache, loss of weight and appetite for 2 months and vomiting for 1½ months. Patient had tonic seizures of all the limbs for one day. Weight of the child was 10.5 kg. Neck rigidity was present. Fundus examination revealed multiple choroid tubercles in right eye and single choroid tubercle in the left (Figs. 1 & 2) along with papilledema in both the eyes. ESR was 18 mm, X-ray chest was normal. Mantoux test was negative. CSF examination was suggestive of tubercular meningitis. CT scan head showed an inflammatory granuloma in left parietal region.

Fig. 1. Showing a choroid tubercle in posterior pole of left fundus.

 
Fig. 2. Showing choroid tubercle as pooling of dye in posterior pole of left fundus on I/V sodium flourescence injection.

Choroid tubercles occur in 13-87 % cases of disseminated tuberculosis and are highly specific for diagnosis of miliary tuberculosis. These are found especially in tubercular meningitis usually as a late event. Ophthal-moscopically. they appear as round pale yellow spots usually near optic disc.

K.K. Locham,
Jaswir Singh,

Department of Pediatrics,
Government Medical College,
Rajindra Hospital,
Patiala 147 001, India.

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