Interstitial Keratitis with Corneal Perforation as the Presenting Sign of Systemic Tuberculosis

Ocul Immunol Inflamm. 2020 Apr 2;28(3):421-423. doi: 10.1080/09273948.2019.1568504. Epub 2019 Feb 26.

Abstract

Background: Ocular surface and corneal involvement in tuberculosis is seldom seen. We report a patient of pulmonary and presumed ocular tuberculosis with immune keratitis along with corneal perforation as the presenting signs.Methods: A middle-aged male presented with stromal keratitis, deep corneal vascularization, and two corneal perforations. Necrotic Mantoux test and cavitary lesion on computerized tomography of the chest clinched the diagnosis of tuberculosis-related interstitial keratitis.Results: Tubercular interstitial keratitis was successfully managed with antitubercular therapy, oral and topical steroids while cyanoacrylate glue was used to seal the corneal perforations.Conclusions: Although corneal involvement is uncommon in ocular tuberculosis, in patients with interstitial keratitis who respond poorly to conventional therapy, a possibility of systemic tuberculosis should be considered in endemic countries.

Keywords: Antitubercular therapy; corneal perforation; interstitial keratitis; ocular tuberculosis.

Publication types

  • Case Reports
  • Letter

MeSH terms

  • Antitubercular Agents / therapeutic use
  • Cornea / diagnostic imaging*
  • Cornea / microbiology
  • Corneal Perforation / diagnosis
  • Corneal Perforation / etiology*
  • Corneal Perforation / microbiology
  • Diagnosis, Differential
  • Humans
  • Keratitis / complications
  • Keratitis / diagnosis*
  • Keratitis / drug therapy
  • Male
  • Middle Aged
  • Mycobacterium tuberculosis / isolation & purification
  • Tomography, X-Ray Computed
  • Tuberculosis / diagnosis
  • Tuberculosis, Ocular / diagnosis*
  • Tuberculosis, Ocular / drug therapy
  • Tuberculosis, Ocular / microbiology

Substances

  • Antitubercular Agents