Primary Conjunctival Tuberculosis

Abstract

A 12-year-old girl was referred to our clinic because of unilateral conjunctivitis not responding to treatment. In the left eye, lower bulbarand tarsal conjunctiva had a polypoidal appearance due to micronodules and there was a subconjunctival nodular mass in the inferiorfornix. Systemic examination was unremarkable except for a left preauricular lymphadenopathy. Excision biopsy of the subconjunctivalmass revealed a granulomatous inflammation with caseation necrosis, but acid-fast bacilli (AFB) was negative. Fine needle-aspirationbiopsy of the preauricular lymph node was performed. In microbiological examination, both AFB and mycobacterial culture werepositive. The isolated mycobacteria strains were identified as Mycobacterium tuberculosis complex and full remission was achieved with 6months of anti-tuberculosis treatment. Although primary tuberculous conjunctivitis is a very rare condition, it should be considered inthe differential diagnosis of treatment-resistant unilateral conjunctivitis. For definitive diagnosis, microbiological and histopathologicalexaminations should be performed both in conjunctiva and regional lymph node.