Choroidal Tubercles
Authors: DONALD MASSARO
Journal: Annals of Internal Medicine (1964)

Article1 February 1964Choroidal TuberclesA Clue to Hematogenous TuberculosisDONALD MASSARO, M.D., SOL KATZ, M.D., MURRAY SACHS, M.D.DONALD MASSARO, M.D.Search for more papers by this author, SOL KATZ, M.D.Search for more papers by this author, MURRAY SACHS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-2-231 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSeveral recent papers lend support to what many clinicians realize, namely, that hematogenous tuberculosis remains a serious problem in regard to morbidity and mortality. Thus, in Chapman and Whorton's (1) autopsy series of 63 cases of miliary tuberculosis a correct antemortem diagnosis was made in only 25 per cent of the cases. Treip and Meyers (2), writing about a 5-year experience, reported the antemortem diagnosis of disseminated tuberculosis in a similar percentage of patients dying of this disease. Böttiger and coworkers (3-4) published several cases of disseminated tuberculosis with essentially negative chest films in whom the diagnosis was not made...References1. CHAPMANWHORTON CBCM: Acute generalized miliary tuberculosis in adults. New Eng. J. Med. 235: 239, 1946. CrossrefMedlineGoogle Scholar2. TREIPMEYERS CD: Fatal tuberculosis in a general hospital a diagnostic problem. Lancet 1: 164, 1959. CrossrefMedlineGoogle Scholar3. BÖTTIGERNORDENSTAM LEHH: Miliary tuberculosis—a forgotten diagnosis. Nord. Med. 66: 1719, 61. MedlineGoogle Scholar4. BÖTTIGERNORDENSTAMWESTER LEHHPO: Disseminated tuberculosis as a cause of fever of obscure origin. Lancet 1: 19, 1962. CrossrefMedlineGoogle Scholar5. PETERSDORFBEESON RGP: Fever of undetermined origin. Medicine 40: 1, 1961. CrossrefMedlineGoogle Scholar6. ILLINGWORTHLORBER RSJ: Tubercles of the choroid. Arch. Dis. Child. 31: 467, 1956. CrossrefMedlineGoogle Scholar7. HAEXVAN BEEK CAC: Tuberculosis and Aspiration Liver Biopsy, DeErven F. Bohn, Haarlem, 1955. Google Scholar8. COHNHEIM S: A. f. path. anat. 39: 49, 1867. (After Duke-Elder, Textbook of Ophthalmology, Vol. 3, p. 2318, 1945, Mosby, St. Louis, Mo.) CrossrefGoogle Scholar9. COHNHEIM S: Berlin. kl. W., IV, 63: 324, 1867 (After Duke-Elder). Google Scholar10. ILLINGWORTHWRIGHT RST: Tubercles of the choroid. Brit. Med. J. 2: 365, 1948. CrossrefMedlineGoogle Scholar11. DEBRÉ R: Miliary tuberculosis in children. Lancet 2: 545, 52. MedlineGoogle Scholar12. EMERYLORBER JLJ: Radiological and pathological correlation of miliary tuberculosis of lungs in children with special reference to choroidal tubercles. Brit. Med. J. 4691: 702, 1950. CrossrefGoogle Scholar13. LORBEREMERY JJL: Use of rectal thiopentone in children. Brit. Med. J. 2: 21, 1950. CrossrefMedlineGoogle Scholar14. MONBRUNLAVAT AJ: Opthalmoscopie et dissemination tuberculose. Bull. Soc. Ophtal. Franc. Google Scholar15. TOOKE F: Tubercles of the choroid associated with generalized miliary tuberculosis. Brit. J. Ophthal. 20: 23, 1936. CrossrefMedlineGoogle Scholar16. DEBRÉTHREFFRYBRESSAUDNOUFFLARD RSEH: Streptomycin and tuberculous meningitis in children. Brit. Med. J. 2: 897, 1947. CrossrefMedlineGoogle Scholar17. MARPLE WB: Tubercle of the choroid in tuberculous meningitis. Ophthalmoscope 10: 559, 1912. Google Scholar18. BREDECK JK: The choroidal tubercle in tuberculous meningitis. Amer. J. Ophthal. 33: 1, 1916. Google Scholar19. TOOKE F: Tuberculous meningitis with special reference to the tubercle of the choroid and its pathological manifestations. Trans. Amer. Ophthal. Soc. 14: 218, 1915-1916. MedlineGoogle Scholar20. RANDOLPHSCHMEISSER RTHC: A clinical and pathological study of two cases of miliary tuberculosis of the choroid. Ibid., p. 585. Google Scholar21. DOLLFUSALBAUGH MACH: Fundus lesions in tuberculous meningitis and miliary pulmonary tuberculosis treated with streptomycin. Amer. J. Ophthal. 32: 821, 1949. CrossrefGoogle Scholar22. KOPLIK J: The clinical history and recognition of tuberculous meningitis. JAMA 48: 1149, 1907. CrossrefGoogle Scholar23. PATON RT: The clinical significance of choroidal tubercles. Ann. Intern. Med. 5: 997, 1932. LinkGoogle Scholar24. MCDERMOTTMUSCHENHEIMHADLEYBUNNGORMAN WCSPARV: Streptomycin in the treatment of tuberculosis in humans. Ann. Intern. Med. 27: 769, 1947. LinkGoogle Scholar25. BAGGENSTOSSFELDMANHINSHAW AHWHHC: The effect of streptomycin on the pathology of generalized miliary and meningeal tuberculosis. Proc. Mayo Clin. 22: 265, 1947. MedlineGoogle Scholar26. MINTON J: Miliary tubercles in the choroid: treatment with streptomycin. Trans. Opthal. Soc. UK 69: 315, 1949. Google Scholar27. DUKE-ELDER WS: Textbook of Ophthalmology, Vol. 3, 1945, Mosby, St. Louis, Mo. Google Scholar28. HOGAN JJ: Ultrastructure of the choroid. Trans. Pacif. Cst Oto-ophthal. Soc. 42: 61, 1961. MedlineGoogle Scholar29. DEOCAMPOESPIRITU GR: Bronchogenic metastatic carcinoma of the choroid. Amer. J. Ophthal. 52: 107, 1961. MedlineGoogle Scholar30. LEMAINEMCLEOD ANJ: Bilateral metastatic carcinoma of choroid—successful x-ray treatment of one eye. Trans. Amer. Ophthal. Soc. 34: 134, 1936. MedlineGoogle Scholar31. LEGRANGE H: La tuberculose du tractus uveal. A. d′O. XLI: 80, 1924. Google Scholar32. FINNOFF WC: Changes found in eyes of rabbits following injection of living tubercle bacilli into the common carotid artery. Amer. J. Ophthal. 7: 81, 1924. CrossrefGoogle Scholar33. SPAIN DM: Pulmonary hematogenous tuberculosis in the adult. Amer. Rev. Tuberc. 56: 249, 1947. Google Scholar34. HANUM S: Clinical studies of 195 cases of retinal changes in diabetics. Acta. Ophth. Supp. 16: 1, 1939. Google Scholar35. PINES N: A clinical study of diabetic retinal angiopathy. Brit. J. Ophthal. 34: 303, 1950. CrossrefMedlineGoogle Scholar36. GARTNER S: Ocular pathology of diabetes. Amer. J. Ophthal. 33: 727, 1950. CrossrefMedlineGoogle Scholar37. KANTAR BL: Diabetic retinopathy. Bull. Univ. Minnesota Hosp. 21: 352, 1950. Google Scholar38. KENNEDYKRICHBAUM RJFM: Ocular fundus findings in 133 cases of diabetes mellitus. Cleveland Clin. Quart. 18: 134, 1951 CrossrefGoogle Scholar39. ELWYN H: Diabetic retinitis. Arch. Ophthal (Chicago) 34: 187, 1945. CrossrefMedlineGoogle Scholar40. WHITTINGTON TH: Discussion on diabetic retinopathy. Proc. Roy. Soc. Med. 44: 753, 1951. Google Scholar41. LARSEN H: Diabetic retinopathy. Acta Opthal. (København) Supp. 60: 1, 1960. MedlineGoogle Scholar42. BEDELL AJ: Diseases of the fundus and optic nerve. Trans. Ophth. Soc. UK 59: 219, 1939. Google Scholar43. LEINFELDER PJ: The retina in the diagnosis of general diseases. Int. Ophthal. Clin. 2: 77, 1962. CrossrefMedlineGoogle Scholar44. WOODS AC: Pathogenesis and treatment of ocular tuberculosis. Arch. Ophthal. (Chicago) 52: 174, 1954. CrossrefMedlineGoogle Scholar45. WOODS AC: Endogenous Inflammation of the Uveal Tract, Williams and Wilkins, Baltimore, 1961. Google Scholar46. MARPLE WB (In discussion of paper by F. Tooke) Trans. Amer. Ophthal. Soc. 14: 218, 1915-1916. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Washington, D. C.From the Pulmonary Disease Service, Veterans Administration Hospital, Washington, D. C. and the Department of Medicine, Georgetown University School of Medicine, Washington, D. C.This paper was presented in part at the Forty-fourth Annual Session of the American College of Physicians, April 2, 1963, Denver, Colorado.Requests for reprints should be addressed to Donald Massaro, M.D., Veterans Administration Hospital, 2650 Wisconsin Avenue, N.W., Washington 7, D. C. 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