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Ocular tuberculosis presenting with a conjunctival granuloma.

H Ben Amor¹, H Krifa², M Mefteh²

¹Service d'ophtalmologie, CHU de Fattouma-Bourguiba, faculté de médecine, université de Monastir, 5019 Monastir, Tunisia; Faculté de médecine, université de Monastir, Monastir, Tunisia.

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|February 1, 2023

Summary

Tuberculosis can cause chronic conjunctivitis, presenting as a vascularized lesion. Prompt biopsy and antituberculosis therapy led to complete resolution in an 18-year-old female patient.

Keywords:

Biopsie Biopsy Conjonctivite Conjunctival granuloma Conjunctivitis Granulome conjonctival Tuberculose Tuberculosis

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Area of Science:

Ophthalmology
Infectious Diseases
Pathology

Background:

Unilateral chronic conjunctivitis can be challenging to diagnose and treat.
Ocular trauma may predispose individuals to certain infections.

Observation:

An 18-year-old female presented with a 3-month history of left eye tearing and redness post-trauma.
Slit-lamp examination revealed a vascularized, polypoidal conjunctival lesion with micronodules.
Biopsy showed tuberculoid granulomas with giant cells and necrosis.

Findings:

Histopathology confirmed granulomatous inflammation consistent with tuberculosis.
A positive Mantoux test (15mm induration) supported the diagnosis.
Antituberculosis therapy resulted in complete resolution of conjunctival lesions within 3 months.

Implications:

Mycobacterium tuberculosis should be considered in recalcitrant unilateral conjunctivitis.
Conjunctival mass biopsy is crucial for definitive diagnosis.
Early diagnosis and treatment of ocular tuberculosis can prevent long-term complications.