Primary Conjunctival Tuberculosis.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Microbiology

Background:

• Unilateral conjunctivitis can present with varied etiologies, posing diagnostic challenges.
• Treatment-resistant cases necessitate a broader differential diagnosis beyond common infections.
• Ocular manifestations of systemic diseases, like tuberculosis, are often overlooked.

Purpose of the Study:

• To report a rare case of primary tuberculous conjunctivitis in a pediatric patient.
• To highlight the diagnostic approach for recalcitrant unilateral conjunctivitis.
• To emphasize the importance of considering tuberculosis in the differential diagnosis.

Main Methods:

• Clinical presentation of a 12-year-old girl with unilateral conjunctivitis.
• Excision biopsy of a subconjunctival mass and fine needle aspiration of preauricular lymph node.
• Histopathological examination, acid-fast bacilli (AFB) staining, and mycobacterial culture.

Main Results:

• Conjunctival biopsy showed granulomatous inflammation with caseation necrosis; AFB was negative.
• Lymph node aspiration revealed positive AFB and mycobacterial culture.
• Identified mycobacteria as Mycobacterium tuberculosis complex, leading to successful treatment.

Conclusions:

• Primary tuberculous conjunctivitis is a rare but important consideration for treatment-resistant unilateral conjunctivitis.
• Microbiological and histopathological examinations of both conjunctiva and regional lymph nodes are crucial for definitive diagnosis.
• Prompt diagnosis and anti-tuberculosis treatment lead to full remission.