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Tuberculous corneal ulcer with hypopyon: A case report.
Neethu Latiff1, Meena Lakshmipathy2, M K Janani3
1Department of Uvea, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, Tamil Nadu, India.
Indian Journal of Ophthalmology
|April 23, 2020
Summary
Tuberculosis can cause rare corneal ulcers with hypopyon, even with negative initial tests. Early diagnosis and antitubercular therapy are crucial for successful treatment of this ocular manifestation.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Microbiology
Background:
- Corneal ulcers are a significant cause of vision loss.
- Ocular tuberculosis is a rare but serious condition.
- Hypopyon corneal ulcers often indicate severe intraocular inflammation or infection.
Observation:
- A 64-year-old male presented with a hypopyon corneal ulcer unresponsive to empirical antimicrobial therapy.
- Initial corneal scrapings were negative for pathogens.
- Real-time polymerase chain reaction (PCR) of aqueous aspirate detected Mycobacterium tuberculosis.
Findings:
- The patient had positive Mantoux and interferon-gamma release assay (IGRA) results.
- Radiological investigations supported the diagnosis of tuberculosis.
- Successful treatment was achieved with antitubercular therapy and topical steroids.
Implications:
- This case highlights Mycobacterium tuberculosis as a potential cause of atypical corneal ulcers.
- Hypopyon corneal ulcers, even with negative initial diagnostics, warrant consideration for ocular tuberculosis.
- Timely diagnosis and appropriate antitubercular treatment are essential for managing this rare ocular manifestation.
