TUBERCULOSIS CHOROIDAL GRANULOMAS IN AIDS PATIENTS - 3 CASE-REPORTS

Tuberculosis choroidal granulomas (''tubercules de Bouchut'') are rare , even in patients with AIDS and active tuberculosis. The authors repo rt the clinical and angiographical findings of three cases. Choroidal involvement tvas bilateral, with multiple lesions, mostly located at t he posterior pole. The size of the granuloma ranged from 1/8 to 1/2 of a disc diameter Fluorescein angiography showed early prolonged hypofl uorescence and late moderate hyperfluorescence. The lesions remained s table for months despite treatment of tuberculosis, and then gradually subsided. In two cases, the choroidal granulomas were discovered befo re the diagnosis of disseminated tuberculosis and guided the investiga tions, which allowed the identification of Mycobacterium Tuberculosis bacillus in the body. In the third case, pulmonary tuberculosis had al ready been diagnosed. The number of tuberculosis cases is increasing t ogether with the number of AIDS cases. This should make the observatio n of tuberculosis choroidal granulomas more frequent The discovery of the typical aspects of granulomas described above during fundus examin ation of AIDS patients can help in diagnosing tuberculosis.