Tuberculous Conjunctivitis in an Anophthalmic Socket

Middle East Afr J Ophthalmol. 2015 Oct-Dec;22(4):525-7. doi: 10.4103/0974-9233.167828.

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.

Keywords: Anophthalmic Socket; Anti-tuberculous Therapy; Enucleation; Miliary Tuberculosis; Tuberculous Conjunctivitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antitubercular Agents / therapeutic use
  • Conjunctivitis, Bacterial / diagnosis*
  • Conjunctivitis, Bacterial / drug therapy
  • Conjunctivitis, Bacterial / microbiology
  • Drug Therapy, Combination
  • Eye Enucleation*
  • Eye Infections, Bacterial / diagnosis*
  • Eye Infections, Bacterial / drug therapy
  • Eye Infections, Bacterial / microbiology
  • Eye Injuries, Penetrating / surgery
  • Female
  • Humans
  • Isoniazid / therapeutic use
  • Orbital Diseases / diagnosis*
  • Orbital Diseases / drug therapy
  • Orbital Diseases / microbiology
  • Pyrazinamide / therapeutic use
  • Rifampin / therapeutic use
  • Tuberculosis, Miliary / diagnosis
  • Tuberculosis, Miliary / drug therapy
  • Tuberculosis, Miliary / microbiology
  • Tuberculosis, Ocular / diagnosis*
  • Tuberculosis, Ocular / drug therapy
  • Tuberculosis, Ocular / microbiology

Substances

  • Antitubercular Agents
  • Pyrazinamide
  • Isoniazid
  • Rifampin