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Tuberculous Conjunctivitis in an Anophthalmic Socket.

Al Habash A, Malik F, Al Abdulsalam O, Al Abdulsalam A - Middle East Afr J Ophthalmol (2015 Oct-Dec)

Bottom Line: Histopathological examination revealed epithelioid granulomas.TB conjunctivitis was suspected from the history of miliary TB and presence of epithelioid granulomas.The definitive diagnosis was made after prompt resolution of the ocular signs with no recurrence only after systemic anti-TB therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, University of Dammam, Dammam, Saudi Arabia.

ABSTRACT
Tuberculous (TB) conjunctivitis was not an uncommon condition before the early 20(th) century but is currently a rare occurrence, especially in the developed countries. We report a 27-year-old Saudi female who underwent enucleation of the right eye at the age of 20 following a penetrating eye injury. She had a history of miliary TB that was treated at the age of 22. She was presented with chronic purulent discharge from her right an anophthalmic socket for 2 months. Cultures for bacteria and fungi were sterile. There was no response to empirical topical antibiotics and steroids. Direct microscopic examination of conjunctival scrapings with the Ziehl-Neelsen staining revealed no microorganisms. Histopathological examination revealed epithelioid granulomas. Polymerase chain reaction was negative for Mycobacterium tuberculosis DNA. TB conjunctivitis was suspected from the history of miliary TB and presence of epithelioid granulomas. The definitive diagnosis was made after prompt resolution of the ocular signs with no recurrence only after systemic anti-TB therapy.

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Photograph of the anophthalmic socket, after treatment with systemic anti-tuberculous therapy
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Figure 2: Photograph of the anophthalmic socket, after treatment with systemic anti-tuberculous therapy

Mentions: The patient started the triple systemic anti-TB therapy using isoniazid (15 mg/kg daily), rifampicin (12 mg/kg daily), and pyrazinamide (20 mg/kg daily), prescribed for 9 months by the infectious disease team. All ocular signs were resolved within 2 months [Figure 2]. No recurrences were observed during a 24-month follow-up period. Based on these findings, the patient was diagnosed with TB conjunctivitis.


Tuberculous Conjunctivitis in an Anophthalmic Socket.

Al Habash A, Malik F, Al Abdulsalam O, Al Abdulsalam A - Middle East Afr J Ophthalmol (2015 Oct-Dec)

Photograph of the anophthalmic socket, after treatment with systemic anti-tuberculous therapy
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660546&req=5

Figure 2: Photograph of the anophthalmic socket, after treatment with systemic anti-tuberculous therapy
Mentions: The patient started the triple systemic anti-TB therapy using isoniazid (15 mg/kg daily), rifampicin (12 mg/kg daily), and pyrazinamide (20 mg/kg daily), prescribed for 9 months by the infectious disease team. All ocular signs were resolved within 2 months [Figure 2]. No recurrences were observed during a 24-month follow-up period. Based on these findings, the patient was diagnosed with TB conjunctivitis.

Bottom Line: Histopathological examination revealed epithelioid granulomas.TB conjunctivitis was suspected from the history of miliary TB and presence of epithelioid granulomas.The definitive diagnosis was made after prompt resolution of the ocular signs with no recurrence only after systemic anti-TB therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, University of Dammam, Dammam, Saudi Arabia.

ABSTRACT
Tuberculous (TB) conjunctivitis was not an uncommon condition before the early 20(th) century but is currently a rare occurrence, especially in the developed countries. We report a 27-year-old Saudi female who underwent enucleation of the right eye at the age of 20 following a penetrating eye injury. She had a history of miliary TB that was treated at the age of 22. She was presented with chronic purulent discharge from her right an anophthalmic socket for 2 months. Cultures for bacteria and fungi were sterile. There was no response to empirical topical antibiotics and steroids. Direct microscopic examination of conjunctival scrapings with the Ziehl-Neelsen staining revealed no microorganisms. Histopathological examination revealed epithelioid granulomas. Polymerase chain reaction was negative for Mycobacterium tuberculosis DNA. TB conjunctivitis was suspected from the history of miliary TB and presence of epithelioid granulomas. The definitive diagnosis was made after prompt resolution of the ocular signs with no recurrence only after systemic anti-TB therapy.

Show MeSH
Related in: MedlinePlus