PRIMARY CONJUNCTIVAL TUBERCULOSIS: A CASE REPORT

Abstract

A 11 year old female was referred from ophthalmology clinic to pulmonary medicine department for further evaluation of a case of unilateral conjunctivitis not responding to treatment as suspected case of conjuctival tuberculosis. In the right eye, bulbar conjunctiva in supranasal quadrant polypoidal appearance was seen and there was subconjunctival cystic nodular mass in the superior conjunctival fornix. Systemic examination was unremarkable. Microbiological and histopathological examination of excision biopsy of the subconjunctival cyst revealed a granulomatous inflammation but acid fast bacilli was negative. Tissue sample was subjected to CBNAAT (Cartridge based nucleic acid amplification technique) examination in which mycobacterium tuberculosis was detected and sensitive to rifampicin. Patient was started on anti tuberculosis treatment under NTEP (national tuberculosis elimination programme) and full remission was achieved with 6 months of anti tuberculosis treatment. Although primary tuberculous conjunctivitis is a very rare condition, it should be considered in the differential diagnosis of treatment-resistant unilateral conjunctivitis. For definitive diagnosis, microbiological, histopathological and molecular examinations should be performed in conjunctival samples.