Tuberculous Scleritis and Multidrug Resistance

Mamta Agarwal, Gazal Patnaik, Shweta Agarwal, Geetha Iyer, A. R. Anand, Gayathri Ar, Jyotirmay Biswas, Manfred Zierhut

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Purpose: To present a case of necrotizing sclerokeratitis in a patient with multidrug-resistant tuberculosis and study the challenges in diagnosis and management of anterior tuberculous scleritis. Methods: Retrospective observational case report and review of anterior tuberculous scleritis. Results: A 28-year-old woman, previously diagnosed as presumed tubercular panuveitis, presented with necrotizing sclerokeratitis and progressed to develop panophthalmitis. Laboratory investigations revealed multidrug-resistant Mycobacterium tuberculosis as the etiological agent. We reviewed cases of anterior tuberculous scleritis published in the literature, with regards to clinical features, microbiological investigations, treatment, and outcomes. Treatment includes standard antitubercular therapy, with or without systemic corticosteroids. Poor response to treatment is seen either due to delayed diagnosis or drug resistance, and the significance of the same is highlighted in our case. Conclusion: Diagnosis of tuberculous scleritis is a challenge. Therapeutic failure must alert the clinician for drug resistance which is diagnosed early, can prevent the devastating outcomes.

Original languageEnglish (US)
Pages (from-to)915-924
Number of pages10
JournalOcular Immunology and Inflammation
Volume30
Issue number4
DOIs
StatePublished - 2022
Externally publishedYes

Keywords

  • Tuberculous scleritis
  • anterior scleritis
  • multi-drug resistance
  • tuberculosis
  • tuberculous panophthalmitis

ASJC Scopus subject areas

  • Immunology and Allergy
  • Ophthalmology

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