Tuberculous scleral abscess with choroidal detachment.

Swapnil Madhukar Parchand, Aswanthi Sadesh Kumar, Subashini Kaliaperumal, Renuka Srinivasan

BMJ case reports 2017 Jan 06

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We present a case of ocular tuberculosis (TB) presenting as scleral abscess with choroidal detachment. A 60-year-old woman presented with intense pain, redness, watering and decreased vision in the right eye (RE) for 1 week duration. Slit lamp examination of RE revealed diffuse scleritis with two pus-pointing areas in the supero-temporal quadrant suggesting scleral abscess. Fundus examination of the RE showed choroidal detachment in the temporal and inferior quadrant. Left eye examination was unremarkable. Ziehl-Neelsen staining of scleral biopsy showed acid-fast bacilli. PCR of the scleral tissue was also positive for Mycobacterium tuberculosis genome. The final diagnosis of tuberculous scleral abscess with choroidal detachment was made and patient showed good response to antitubercular treatment. In countries endemic for TB, it should be considered as a differential diagnosis for scleral abscess, since prompt diagnosis and treatment will ensure good visual outcome as depicted in our case. 2017 BMJ Publishing Group Ltd.

Citation

Swapnil Madhukar Parchand, Aswanthi Sadesh Kumar, Subashini Kaliaperumal, Renuka Srinivasan. Tuberculous scleral abscess with choroidal detachment. BMJ case reports. 2017 Jan 06;2017