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Reducción de la lesión sin signos de actividad.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Macías-Franco, M. Fernández-García, C. Costales-Álvarez, J. Mayordomo-Colunga, P. Rozas-Reyes" "autores" => array:5 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Macías-Franco" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Fernández-García" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Costales-Álvarez" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Mayordomo-Colunga" ] 4 => array:2 [ "nombre" => "P." "apellidos" => "Rozas-Reyes" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579419301963" "doi" => "10.1016/j.oftale.2019.09.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579419301963?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669119302965?idApp=UINPBA00004N" "url" => "/03656691/0000009500000001/v2_202108150636/S0365669119302965/v2_202108150636/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2173579419301914" "issn" => "21735794" "doi" => "10.1016/j.oftale.2019.09.006" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "1576" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2020;95:45-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Delayed infectious keratitis in a patient with radial keratotomy and floppy eyelid syndrome treated with simple interrupted stitches" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "45" "paginaFinal" => "47" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Queratitis infecciosa tardía en paciente con queratotomía radial y síndrome de párpado flácido tratado con puntos sueltos" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 749 "Ancho" => 755 "Tamanyo" => 98873 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Left eye slit lamp examination. (A) Mild conjunctival hyperaemia and corneal irregular infiltrate affecting one of the incisions. (B) Intensive conjunctival injection, deep corneal infiltrate and hypopyon. (C) Evolution after topical vancomycin, ciprofloxacin and voriconazole treatment, showing hypopyon resolution and persistence of corneal infiltrate and conjunctival injection. (D) Corneal infiltrate resolution after interrupted single stitches.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Rahhal-Ortuño, A.S. Fernández-Santodomingo, M. Hurtado-Sarrió" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Rahhal-Ortuño" ] 1 => array:2 [ "nombre" => "A.S." "apellidos" => "Fernández-Santodomingo" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Hurtado-Sarrió" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669119302953" "doi" => "10.1016/j.oftal.2019.09.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669119302953?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579419301914?idApp=UINPBA00004N" "url" => "/21735794/0000009500000001/v1_202001140744/S2173579419301914/v1_202001140744/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2173579419301975" "issn" => "21735794" "doi" => "10.1016/j.oftale.2019.09.011" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "1579" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2020;95:38-41" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Changes in ocular motility in Kabuki syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "38" "paginaFinal" => "41" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Alteraciones de la motilidad ocular en el síndrome de Kabuki" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 678 "Ancho" => 905 "Tamanyo" => 47415 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Bilateral ptosis with hyperaction of RE lower oblique.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I. del Cerro, P. Merino, P. Gómez de Liaño, G. Alan" "autores" => array:4 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "del Cerro" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Merino" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Gómez de Liaño" ] 3 => array:2 [ "nombre" => "G." "apellidos" => "Alan" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669119302989" "doi" => "10.1016/j.oftal.2019.09.016" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669119302989?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579419301975?idApp=UINPBA00004N" "url" => "/21735794/0000009500000001/v1_202001140744/S2173579419301975/v1_202001140744/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "titulo" => "Miliary tuberculosis and choroidal tuberculoma in a three-month old baby girl: Diagnosis and follow-up of a case" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "42" "paginaFinal" => "44" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "S. Macías-Franco, M. Fernández-García, C. Costales-Álvarez, J. Mayordomo-Colunga, P. Rozas-Reyes" "autores" => array:5 [ 0 => array:4 [ "nombre" => "S." "apellidos" => "Macías-Franco" "email" => array:1 [ 0 => "sandramacfran@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M." "apellidos" => "Fernández-García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Costales-Álvarez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "J." "apellidos" => "Mayordomo-Colunga" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 4 => array:3 [ "nombre" => "P." "apellidos" => "Rozas-Reyes" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Oftalmología, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Pediatría, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tuberculosis miliar y tuberculoma coroideo en una niña de 3 meses: Diagnóstico y seguimiento de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 648 "Ancho" => 905 "Tamanyo" => 53515 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Yellow-grayish lesion without vitreous compromise (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Tuberculosis is regarded as a global health problem. The 2018 annual report of the World Health Organization estimated the incidence of tuberculosis at 10,000,000 cases in 2017, of which one million were under 15 years of age. At present, tuberculosis continues to be the infectious disease that causes the highest number of deaths in the world, amounting to 1.6 million people, 15 % of them in pediatric age.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Even though the incidence and mortality of pediatric tuberculosis in our country is exceptional, early diagnostic is very important due to the susceptibility of this age group to rapid progression from latent infection up to symptomatic disease and extrapulmonary forms that give rise to significant complications.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> If we add the problem of strain resistance to anti-tuberculosis drugs, which exhibit higher prevalence than shown in adults, the difficulty of defining the therapeutic approach increases.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> Virtually any organ could be attacked although ocular compromise is infrequent, including granulomatous uveitis and tuberculous choroiditis as most common expressions due to rich uveal vascularization facilitating the dissemination of the bacillus.</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Clinic case report</span><p id="par0010" class="elsevierStylePara elsevierViewall">Lactating infant, 3 months old, taken to the Pediatric Emergency Department due to fever with one day evolution. After normal examination and absence of alterations in hemogram and biochemistry, the patient was followed up on an ambulatory basis. In the absence of improvements and appearance of catarrh symptoms, continuous fever at 38.9 °C and increases in acute phase and reactant values it was decided to admit the patient for study. The fourth day of hospital stay, the patient had an episode of poor general condition, change of color and rejection of nutrition so it was taken to the Intensive Pediatric Care Unit. During her stay and after discarding other causes of infection, positive Mantoux result suggested tuberculosis, whereupon oral treatment was initiated with 4 medicaments: isoniazid + rifampicin + pyrazinamide + ethambutol.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The positive evolution of the patient led to discharge from the Intensive Pediatric Care Unit and readmission to the hospitalization section where she remained stable during 4–5 days, at which point fever clinic returned. Disease extension studies were increased to include imaging tests, lumbar puncture and serology as well as requesting an appointment with the Ophthalmology Dept. The ophthalmological examination showed that the patient could fix the gaze and followed objects with one in both eyes as well as exhibiting transparency without signs of anterior uveitis. The funduscopic examination of the left eye produced a yellowish-grayish rounded choroidal lesion without associating vitreous compromise suggesting turberculous posterior uveitis (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The right eye did not produce findings.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Said finding, together with positive Quanti-feron-TB Gold and the presence of lesions in the liver and spleen and pulmonary alterations in the image tests confirmed the suspicion of miliary or disseminated tuberculosis.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Intravenous amikacin and isoniazid were administered, preserving the rest of oral therapy through nasogastric probe due to repeated vomiting. In addition, due to the choroidal lesion it was decided to introduce intravenous corticoid therapy, also switching the administration pathway of ethambutol and rifampicin to intravenous.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Said fivefold therapy produced a positive response. In the follow-up, the choroidal lesion size diminished and evolved positively towards a cicatricial appearance (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Lastly, the entire treatment was switched to oral, suspending amikacin and releasing the patient to home care with regular checkups.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Overall, isoniazid and rifampicin were administered during 12 months, pyrazinamide and ethambutol during 2 months and corticoid therapy was administered in a progressively diminishing pattern during 3 months.</p></span></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0045" class="elsevierStylePara elsevierViewall">Ocular tuberculosis is relatively infrequent, could emerge in isolation or in the context of the disseminated disease, typically knownmiliary tuberculosis. The authors prefer to define itextrapulmonary or disseminated tuberculosis to avoid confusion with the radiologic description that defines the pulmonary disease. Disseminated tuberculosis canconsidered as|as|be|as, a systemic disease in which the microorganism usually expands along the hematogenous pathway from the lungs, with the ability to reach any ocular or orbital tissue. Choroidal compromise is characterized by caseous granuloma-type tissue response, presents as, a single, grayish yellow choroidal lesion with undefined edges, typical central elevation (choroidal tuberculoma) or as, multiple(choroidal tuberculoma), well-defined, smaller choroidal lesions. These presentations could associate hemorrhages, (choroidal tubercules), exudates, edema. Vitreous compromise is exceptional. In another form of choroidal compromise, the disease expresses as, serpiginous-like posterior uveitis clinic.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The microorganism can also directly affect the eye due to adjacency. This is more frequent in anterior segment infections such as keratitis involving primary tuberculosis in which systemic dissemination is rare. In addition, inflammatory ocular compromise is the result of a type IV hypersensitivity reaction to antigen components of the Mycobacterium typical of phlyctenulosis and some tuberculous uveitis.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Even though ocular compromise is known since the 19th century, when said choroidal “tubercules” were described half a century before Robert Koch identified the bacillus,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> imprecise diagnostic criteria, the complexity of accessing and processing ophthalmological samples as well as the absence of symptoms in many cases has made it difficult to estimate the incidence and prevalence of ocular tuberculosis. Accordingly, some series report an incidence of ocular tuberculosis of 1 %<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> on the one hand, and on the other a surprising prospective randomized 1997 study of a cohort of 100 patients diagnosed with systemic tuberculosis in Spain in which ocular compromise reached 18 %.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> In the present case, the positive Mantoux test in the context of a localized fever oriented the diagnostic and enabled a quick reaction. Supplementary tests, with radiological changes and the presence of other extrapulmonary lesions, including the ophthalmoscopic finding of the typical choroidal lesion, reinforced the disseminated tuberculosis diagnostic.</p><p id="par0060" class="elsevierStylePara elsevierViewall">In what concerns treatment, ocular tuberculosis is treated as an active or extrapulmonary lung tuberculosis. On the basis of World Health Organization recommendations, treatment for children comprises 6 months of quadruple antibiotic therapy with rifampicin, isoniazid, ethambutol and pyrazinamide during the first 8 weeks followed by rifampicin and isoniacid the following 18 weeks. On the other hand, the use of corticosteroids is justified for controlling inflammation: treatment is initiated after the first 48 h and maintained during 6–12 weeks. Recently, members of the the Spanish Network of Pediatric Tuberculosis and the Working Group for Tuberculosis and Other Micobacterian Infections of the Pediatric Infectology Society of Spain published an updated review of the treatment of tuberculosis in children.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Overall, the duration of the treatment for disseminated tuberculosis with isoniazid and rifampicin ranges between 6 and 12 months. The rise of resistant strains has led to the inclusion of fluoroquinolones and aminoglycosides such as amikacin. Due to the age of the present patient, the authors were unable to determine compromise of visual acuity although extramacular location indicates that this was not the case. At the time of writing, the patient does not exhibit signs of amblyopia.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Funding</span><p id="par0065" class="elsevierStylePara elsevierViewall">The present research has not received specific funding from public sector agencies, the commercial industry or nonprofit institutions.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conflict of interests</span><p id="par0070" class="elsevierStylePara elsevierViewall">No conflict of interests was declared by the authors</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1285916" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1188502" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1285917" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1188501" "titulo" => "Palabras clave" ] 4 => array:3 [ "identificador" => "sec0005" "titulo" => "Introduction" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinic case report" ] ] ] 5 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0020" "titulo" => "Funding" ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflict of interests" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-05-17" "fechaAceptado" => "2019-09-26" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1188502" "palabras" => array:4 [ 0 => "Miliar tuberculosis" 1 => "Ocular tuberculosis" 2 => "Choroidal tuberculoma" 3 => "Pediatric tuberculosis." ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1188501" "palabras" => array:4 [ 0 => "Tuberculosis miliar" 1 => "Tuberculosis ocular" 2 => "Tuberculoma coroideo" 3 => "Tuberculosis pediátrica." ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A three-month old baby girl is presented with fever without source and with signs of worsening of this episode. Fundoscopy showed a solitary choroidal lesión in her left eye and extraocular lesions suggesting disseminated tuberculosis (TB). A favorable outcome was achieved after quadruple antibiotic therapy and corticotherapy.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Disseminated TB should be considered in cases of fever without source in children with unsatisfactory evolution. Ocular examination is mandatory due to possible posterior uveítis signs that can help with early diagnosis and treatment of some diseases.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se presenta a una niña de 3 meses de edad con un cuadro febril sin foco y empeoramiento del mismo. La exploración fundoscópica mostró una lesión coroidea en el ojo izquierdo junto con lesiones en otros órganos sugestivas de tuberculosis (TB) diseminada. La evolución fue favorable tras tratamiento con cuádruple terapia antibiótica asociada a corticoterapia.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La TB diseminada debe tenerse en cuenta ante un cuadro febril de tórpida evolución. La exploración oftalmológica de estos pacientes es fundamental ya que aunque es poco frecuente, los signos característicos de las uveítis posteriores nos orientarán hacia el diagnóstico y tratamiento precoz de esta enfermedad.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Macías-Franco S, Fernández-García M, Costales-Álvarez C, Mayordomo-Colunga J, Rozas-Reyes P. Tuberculosis miliar y tuberculoma coroideo en una niña de 3 meses: Diagnóstico y seguimiento de un caso. Arch Soc Esp Oftalmol. 2020;95:42–44.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 648 "Ancho" => 905 "Tamanyo" => 53515 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Yellow-grayish lesion without vitreous compromise (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article).</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 840 "Ancho" => 905 "Tamanyo" => 45845 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Post-treatment appearance. 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