Tuberculosis presenting as posttraumatic panophthalmitis.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Panophthalmitis, a severe eye inflammation, is a rare manifestation of tuberculosis (TB).
• TB-related eye infections typically occur in immunocompromised individuals, children, or those with a history of drug abuse.
• This report details an unusual case of tubercular panophthalmitis in an otherwise healthy adult.

Observation:

• A 46-year-old female developed corneal infiltrate and endophthalmitis after a wooden object injury to her right eye.
• Initial corneal scrapings and vitreous samples were sterile, and the patient did not respond to antibiotics.
• The condition progressed to panophthalmitis, necessitating eye evisceration.

Findings:

• Histopathology of the eviscerated eye revealed granulomatous inflammation and acid-fast bacilli, confirming tuberculosis.
• No systemic TB focus was identified in the patient.
• The patient successfully completed a 6-month anti-tubercular therapy regimen.

Implications:

• This case underscores that tuberculosis can present atypically, even as a direct post-traumatic ocular infection.
• Ocular tuberculosis should be included in the differential diagnosis for severe post-traumatic endophthalmitis and panophthalmitis, particularly in TB-endemic regions.
• Direct inoculation of Mycobacterium tuberculosis during ocular trauma is a rare but possible route of infection.