Tuberculous endogenous endophthalmitis presenting acute anterior uveitis with hypopyon

A 27-year-old male with pain, redness, and vision loss in the right eye was diagnosed with acute anterior uveitis with hypopyon and treated with topical corticosteroid and cycloplegic eyedrops. Two weeks later, he developed severe vitritis. Then, after 1 month of oral corticosteroid treatment, his c...

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Main Authors: M. Mejbahul Alam, Zahedur Rahman, Krishnakumar Subramanian, Parthopratim Dutta Majumder
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-05-01
Series:Oman Journal of Ophthalmology
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Online Access:https://journals.lww.com/10.4103/ojo.ojo_87_24
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author M. Mejbahul Alam
Zahedur Rahman
Krishnakumar Subramanian
Parthopratim Dutta Majumder
author_facet M. Mejbahul Alam
Zahedur Rahman
Krishnakumar Subramanian
Parthopratim Dutta Majumder
author_sort M. Mejbahul Alam
collection DOAJ
description A 27-year-old male with pain, redness, and vision loss in the right eye was diagnosed with acute anterior uveitis with hypopyon and treated with topical corticosteroid and cycloplegic eyedrops. Two weeks later, he developed severe vitritis. Then, after 1 month of oral corticosteroid treatment, his condition did not improve; therefore, he underwent pars plana vitrectomy with intravitreal antimicrobial injection in the right eye with suspicion of endogenous endophthalmitis. Polymerase chain reaction (PCR) from vitreous aspirate were negative for herpes viruses, eubacterial and panfungal genomes. After 3 months, the patient developed a painful blind eye and was eviscerated. Histopathology and PCR from ocular specimens confirmed the presence of Mycobacterium tuberculosis. High-resolution computed tomography chest showed calcific nodules in the upper lobe of the right lung, and the Mantoux test was positive. Further inquiry revealed that the patient’s father had pulmonary tuberculosis (TB) 4 years earlier. Ocular TB remains a great masquerader; the clinicians in the TB-endemic region must bear a high index of suspicion of TB while managing a case of endogenous endophthalmitis.
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publishDate 2025-05-01
publisher Wolters Kluwer Medknow Publications
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spelling doaj-art-6b0bbbfb932e4f7482bc3764147a7e702025-08-20T03:15:42ZengWolters Kluwer Medknow PublicationsOman Journal of Ophthalmology0974-620X0974-78422025-05-0118222122310.4103/ojo.ojo_87_24Tuberculous endogenous endophthalmitis presenting acute anterior uveitis with hypopyonM. Mejbahul AlamZahedur RahmanKrishnakumar SubramanianParthopratim Dutta MajumderA 27-year-old male with pain, redness, and vision loss in the right eye was diagnosed with acute anterior uveitis with hypopyon and treated with topical corticosteroid and cycloplegic eyedrops. Two weeks later, he developed severe vitritis. Then, after 1 month of oral corticosteroid treatment, his condition did not improve; therefore, he underwent pars plana vitrectomy with intravitreal antimicrobial injection in the right eye with suspicion of endogenous endophthalmitis. Polymerase chain reaction (PCR) from vitreous aspirate were negative for herpes viruses, eubacterial and panfungal genomes. After 3 months, the patient developed a painful blind eye and was eviscerated. Histopathology and PCR from ocular specimens confirmed the presence of Mycobacterium tuberculosis. High-resolution computed tomography chest showed calcific nodules in the upper lobe of the right lung, and the Mantoux test was positive. Further inquiry revealed that the patient’s father had pulmonary tuberculosis (TB) 4 years earlier. Ocular TB remains a great masquerader; the clinicians in the TB-endemic region must bear a high index of suspicion of TB while managing a case of endogenous endophthalmitis.https://journals.lww.com/10.4103/ojo.ojo_87_24antituberculosis treatmentendophthalmitishypopyonocular tuberculosisvitritis
spellingShingle M. Mejbahul Alam
Zahedur Rahman
Krishnakumar Subramanian
Parthopratim Dutta Majumder
Tuberculous endogenous endophthalmitis presenting acute anterior uveitis with hypopyon
Oman Journal of Ophthalmology
antituberculosis treatment
endophthalmitis
hypopyon
ocular tuberculosis
vitritis
title Tuberculous endogenous endophthalmitis presenting acute anterior uveitis with hypopyon
title_full Tuberculous endogenous endophthalmitis presenting acute anterior uveitis with hypopyon
title_fullStr Tuberculous endogenous endophthalmitis presenting acute anterior uveitis with hypopyon
title_full_unstemmed Tuberculous endogenous endophthalmitis presenting acute anterior uveitis with hypopyon
title_short Tuberculous endogenous endophthalmitis presenting acute anterior uveitis with hypopyon
title_sort tuberculous endogenous endophthalmitis presenting acute anterior uveitis with hypopyon
topic antituberculosis treatment
endophthalmitis
hypopyon
ocular tuberculosis
vitritis
url https://journals.lww.com/10.4103/ojo.ojo_87_24
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AT zahedurrahman tuberculousendogenousendophthalmitispresentingacuteanterioruveitiswithhypopyon
AT krishnakumarsubramanian tuberculousendogenousendophthalmitispresentingacuteanterioruveitiswithhypopyon
AT parthopratimduttamajumder tuberculousendogenousendophthalmitispresentingacuteanterioruveitiswithhypopyon