Autoimmune keratitis in mycobacterium tuberculosis

  • Purpose: To report a case of autoimmune keratitis in a patient with mycobacterium tuberculosis (MBT). Methods: An 84-year-old male with pulmonary tuberculosis (TB) was admitted with chronic, non-healing bilateral ulcerations of the inferior peripheral cornea associated with stromal and subconjunctival nodules. Results: Clinical examination revealed circumscribed peripheral corneal ulceration with whitish nodules in adjacent stromal and subconjunctival tissue. Microbiological cultures of the corneal tissue were negative for MBT and other microbial pathogens; however, enzyme-linked immunosorbent assay (ELISA) of blood and corneal samples showed significantly elevated levels of IgM and IgA against MBT. In addition to systemic anti-tuberculosis therapy, the patient was treated topically with Polyspectran® eye drops, Dexamethasone eye drops, and Bepanthen® ointment, for 2 weeks. Both eyes showed dramatic improvement after 2 weeks. Conclusion: The present report demonstrates that MBT is able to initiate delayed autoimmune response within the corneal tissue during an intensive phase of anti-tuberculosis treatment.

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Author:Parviz Rafiezadeh, Ingo SchmackORCiDGND, Mehdi ShajariGND, Thomas KohnenORCiDGND
Parent Title (English):Journal of current ophthalmology
Place of publication:Amsterdam
Document Type:Article
Date of Publication (online):2018/11/29
Date of first Publication:2018/05/18
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2023/10/31
Tag:Autoimmune response; Ocular tuberculosis; Phlyctenule; Scrofulous keratitis
Page Number:3
First Page:381
Last Page:383
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - CC BY-NC-ND - Namensnennung - Nicht kommerziell - Keine Bearbeitungen 4.0 International