Never Forget the Optic Fundi in Tuberculosis!

We evaluated a 5-year-old boy with high-grade, intermittent fever, weight loss, and episodic nonprojectile vomiting for the previous 2 months. There was no associated abdominal pain, jaundice, chronic cough, bleeding manifestations, altered sensorium, seizures, or focal motor or visual deficits. Perinatal period and development was normal. He was immunized for age. Family history was not contributory. On examination, he had pallor, cervical lymphadenopathy, failure to thrive, tachypnea, meningismus, and small, yellowish–white active choroiditis lesions (choroidal tubercles) as well as healed choroiditis scars in the left eye (Figure, A at presentation and Figure B at follow-up for comparison).

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