S Trad1, B Bodaghi2,3, D Saadoun4,5,6,7. 1. a Internal Medicine Department , AP-HP, Ambroise-Paré Hospital , Boulogne-Billancourt , France. 2. b Ophthalmology Department , AP-HP, Groupe Hospitalier Pitié-Salpêtrière , Paris , France. 3. c Sorbonne Universités , UPMC Univ Paris, UMR 7211 , Paris , France. 4. d Inflammation-Immunopathology-Biotherapy Department (DHU i2B) , Paris , France. 5. e INSERM , UMR_S 959 , Paris , France. 6. f CNRS , FRE3632, Paris , France. 7. g Department of Internal Medicine and Clinical Immunology , AP-HP, Groupe Hospitalier Pitié-Salpêtrière , Paris , France.
Abstract
PURPOSE: To clarify interferon-gamma release assay (IGRA) contributions to intraocular tuberculosis management, according to related TB endemic prevalence. METHODS: Despite extensive investigations, including IGRA, the diagnosis of intraocular tuberculosis (TB) is still challenging and remains mostly presumptive. According to the literature, it appears that management of suspected ocular TB differs significantly based on whether patients are from areas of high TB prevalence or from non-TB-endemic countries. The accuracy and final contribution of chest X-rays, tuberculin skin test and IGRA differ significantly according to low or high endemic TB areas. This work aims to review IGRA test outcomes in the light of these clinical and epidemiological settings. We therefore focused our analysis and its subsequent guidelines proposal based on the TB prevalence where the patient lives. CONCLUSION: We believe that distinct guidelines should be determined for managing patients with suspected ocular TB, first taking into consideration the relative TB prevalence.
PURPOSE: To clarify interferon-gamma release assay (IGRA) contributions to intraocular tuberculosis management, according to related TB endemic prevalence. METHODS: Despite extensive investigations, including IGRA, the diagnosis of intraocular tuberculosis (TB) is still challenging and remains mostly presumptive. According to the literature, it appears that management of suspected ocular TB differs significantly based on whether patients are from areas of high TB prevalence or from non-TB-endemic countries. The accuracy and final contribution of chest X-rays, tuberculin skin test and IGRA differ significantly according to low or high endemic TB areas. This work aims to review IGRA test outcomes in the light of these clinical and epidemiological settings. We therefore focused our analysis and its subsequent guidelines proposal based on the TB prevalence where the patient lives. CONCLUSION: We believe that distinct guidelines should be determined for managing patients with suspected ocular TB, first taking into consideration the relative TB prevalence.
Authors: Luis Anibarro; Eliana Cortés; Ana Chouza; Alberto Parafita-Fernández; Juan Carlos García; Alberto Pena; Carlos Fernández-Cid; África González-Fernández Journal: Infection Date: 2018-06-04 Impact factor: 3.553