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.