Bilateral Interstitial Keratitis and Granulomatous Uveitis of Tubercular Origin

Kamal, Saurabh; Kumar, Rahul; Kumar, Sushil; Goel, Ruchi

doi:10.1097/icl.0b013e31827a025e

Cited by 16 publications

(12 citation statements)

References 9 publications

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“… 10 Patients with immunologic reactions to MBT usually present with unilateral peripheral ulcerative keratitis (PUK) or immune stromal interstitial keratitis; however, bilateral central interstitial or disciform keratitis has also been described. 11 , 12 The differential diagnosis includes infectious diseases like Lyme disease, Epstein-Barr virus, herpes simplex virus, varicella-zoster virus or syphilis, and non-infectious conditions such as rheumatoid arthritis. 11 , 12 …”

Section: Discussionmentioning

confidence: 99%

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Autoimmune keratitis in mycobacterium tuberculosis

Rafiezadeh

Schmack

Shajari

et al. 2018

Journal of Current Ophthalmology

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PurposeTo report a case of autoimmune keratitis in a patient with mycobacterium tuberculosis (MBT).MethodsAn 84-year-old male with pulmonary tuberculosis (TB) was admitted with chronic, non-healing bilateral ulcerations of the inferior peripheral cornea associated with stromal and subconjunctival nodules.ResultsClinical examination revealed circumscribed peripheral corneal ulceration with whitish nodules in adjacent stromal and subconjunctival tissue. Microbiological cultures of the corneal tissue were negative for MBT and other microbial pathogens; however, enzyme-linked immunosorbent assay (ELISA) of blood and corneal samples showed significantly elevated levels of IgM and IgA against MBT. In addition to systemic anti-tuberculosis therapy, the patient was treated topically with Polyspectran® eye drops, Dexamethasone eye drops, and Bepanthen® ointment, for 2 weeks. Both eyes showed dramatic improvement after 2 weeks.ConclusionThe present report demonstrates that MBT is able to initiate delayed autoimmune response within the corneal tissue during an intensive phase of anti-tuberculosis treatment.

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Section: Discussionmentioning

confidence: 99%

“… 11 , 12 The differential diagnosis includes infectious diseases like Lyme disease, Epstein-Barr virus, herpes simplex virus, varicella-zoster virus or syphilis, and non-infectious conditions such as rheumatoid arthritis. 11 , 12 …”

Section: Discussionmentioning

confidence: 99%

Autoimmune keratitis in mycobacterium tuberculosis

Rafiezadeh

Schmack

Shajari

et al. 2018

Journal of Current Ophthalmology

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“…However, direct involvement by the bacilli is not uncommon and has been reported widely in the literature. [ 1 6 ] Corneal involvement in ocular tuberculosis includes interstitial keratitis,[ 7 ] disciform keratitis,[ 8 ] and stromal keratitis. [ 9 ] Similarly, the reports on hypopyon uveitis in association with tuberculous infection are increasing in number.…”

Section: Discussionmentioning

confidence: 99%

Tuberculous corneal ulcer with hypopyon: A case report

Latiff

Lakshmipathy

Janani

et al. 2020

Indian J Ophthalmol

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This case report represents an unusual presentation of Mycobacterium tuberculosis -associated corneal ulcer with hypopyon. A 64-year-old man presented with a hypopyon corneal ulcer in the right eye. His corneal scrapings were negative, and the ulcer was not responding to empirical antimicrobial therapy. A real-time polymerase chain reaction from an aqueous aspirate of the right eye detected 422 copies of M. tuberculosis . Subsequent investigations revealed positive Mantoux and interferon-gamma release assay, supportive radiology. The patient was successfully treated with a course of antitubercular therapy and topical steroids. Hypopyon corneal ulcer, though a rare manifestation of ocular tuberculosis, should be considered in cases not responding to standard antimicrobial therapy.

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“…It is usually seen as unilateral inferior stromal infiltration or unilateral immune stromal interstitial keratitis due to late hypersensitivity reaction. Bilateral central interstitial keratitis [ 4 ] and bilateral disciform keratitis [ 5 ] are other atypical corneal involvements which have been reported before. Gupta et al [ 6 ] isolated M. tuberculosis on histopathological examination of a case with Sweet's syndrome who presented with PUK and scleral nodules.…”

Section: Discussionmentioning

confidence: 99%

Ocular Tuberculosis with Progressive Unilateral Corneal Melting

Bayraktutar

Uçakhan-Gündüz

2015

Case Rep Ophthalmol

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Objectives: In this case report, we present a patient with ocular tuberculosis presenting with progressive unilateral corneal melting. Patient: A 47-year-old female was admitted with melting at the inferior half of the peripheral cornea and inferior subconjunctival nodules. Biopsy material of the nodules was negative for tuberculosis bacillus. However, polymerase chain reaction of the biopsy sample revealed the DNA of the bacillus, and the diagnosis was confirmed. Conclusion: In endemic areas, ocular tuberculosis should be kept in mind in the differential diagnosis of patients with chronic and atypical corneal involvement.

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Bilateral Interstitial Keratitis and Granulomatous Uveitis of Tubercular Origin

Abstract: Bilateral central IK with granulomatous uveitis is probably related to the presence of tubercular antigen in aqueous humor. Positive QuantiFERON-TB Gold test is useful for initiating the antitubercular treatment where unusual presentation is encountered.

Cited by 16 publications

References 9 publications

Autoimmune keratitis in mycobacterium tuberculosis

Autoimmune keratitis in mycobacterium tuberculosis

Tuberculous corneal ulcer with hypopyon: A case report

Ocular Tuberculosis with Progressive Unilateral Corneal Melting

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