Case report: atypical presentation of Mycobacterium tuberculosis uveitis preceding nodular scleritis

BMC Infectious Diseases

Usanee Reinprayoon¹  Prasart Laksanaphuk¹  Anita Manassakorn¹  Sunee Chansangpetch¹ 

[1] Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, 1873 Rama 4 Road, Pathumwan 10330, Bangkok, Thailand

关键词: Intraocular inflammation;    Phacolytic glaucoma;    Nodular scleritis;    Uveitis;    Mycobacterium tuberculosis;   

Others  :  1232743
DOI  :  10.1186/s12879-015-1221-4

 received in 2015-07-08, accepted in 2015-10-15,  发布年份 2015

【 摘 要 】

Background

Intraocular tuberculosis is uncommon and has various clinical presentations. Lack of specific clinical clues can make the diagnosis challenging. The purpose of this study is to report a clinical presentation of tuberculous iridocyclitis that mimics phacolytic glaucoma and has a distinctive inflammatory deposit in the inner side of the cornea. This report is the first to describe the progression of tuberculous iridocyclitis to nodular scleritis without evidence for extraocular tuberculous infection.

Case presentation

A 78-year-old, immunocompetent woman presented with subacute intraocular inflammation with high intraocular pressure, mimicking phacolytic glaucoma. Distinct pigment keratic precipitates were noted on the first visit. Even though the cataract extraction was uneventful and adequate anti-inflammatory drugs were given, the inflammation did not subside as expected. Seven weeks later, she developed two scleral abscesses, which were subsequently explored for microbiological investigation. The smears of the pus revealed positive acid-fast bacilli stain and PCR for Mycobacterium tuberculosis complex. Eventually, the pus culture grew Mycobacterium tuberculosis. Anti-tuberculosis medications were prescribed. After 1 month of treatment, the abscesses were cured. However, her visual acuity did not improve at the last visit.

Conclusions

This case revealed an unusual presentation and untreated course of tuberculosis iridocyclitis. Pattern of keratic precipitates may indicate the presence of tuberculosis.

【 授权许可】

   
2015 Chansangpetch et al.

【 图 表 】

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