Abstract
Due to their non-specific diagnostic patterns of ocular infection, differential diagnosis between Mycobacterium (M.) chimaera and tuberculosis can be challenging. In both disorders, ocular manifestation can be the first sign of a systemic infection, and a delayed diagnosis might reduce the response to treatment leading to negative outcomes. Thus, it becomes imperative to distinguish chorioretinal lesions associated with M. chimaera, from lesions due to M. tuberculosis and other infectious disorders. To date, multimodal non-invasive imaging modalities that include ultra-wide field fundus photography, fluorescein and indocyanine green angiography, optical coherence tomography and optical coherence tomography angiography, facilitate in vivo examination of retinal and choroidal tissues, enabling early diagnosis, monitoring treatment response, and relapse detection. This approach is crucial to differentiate between active and inactive ocular disease, and guides clinicians in their decisional-tree during the patients’ follow-up. In this review, we summarized and compared the available literature on multimodal imaging data of M. chimaera infection and tuberculosis, emphasizing similarities and differences in imaging patterns between these two entities and highlighting the relevance of multimodal imaging in the management of the infections.
Highlights
Mycobacterium (M.) belongs to the genus of Actinobacteria, which consists of over190 species, some of them causing serious health diseases in humans [1]
The most common pathogen is M. tuberculosis, which has a panoply of systemic manifestations, including ocular manifestations [1,2]
Differential diagnosis of ocular lesions can be often challenging, in this review we summarized and compared the available literature on ocular multimodal imaging data of M. chimaera and TB, emphasizing similarities and differences in imaging patterns between these two entities and highlighting the relevance of multimodal imaging in the management of the infections
Summary
Mycobacterium (M.) belongs to the genus of Actinobacteria, which consists of over. 190 species, some of them causing serious health diseases in humans [1]. Since 2013, there has been an unprecedented increase in the incidence of M. chimaera infections, especially among individuals undergoing cardiopulmonary bypass surgery It is primarily transmitted via thermoregulatory components of extracorporeal membrane oxygenation (ECMO) systems and water tanks of heater-cooler units (HCUs) [5,6]. Since M. chimaera affected cases have been reported in 11 other countries, including Canada, the USA, Europe, and Australia [11,12]. Both M. chimaera and M. tuberculosis cause disseminated infections, inducing granulomatous inflammation in multiple organs [6,13]. Differential diagnosis of ocular lesions can be often challenging, in this review we summarized and compared the available literature on ocular multimodal imaging data of M. chimaera and TB, emphasizing similarities and differences in imaging patterns between these two entities and highlighting the relevance of multimodal imaging in the management of the infections
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