Phlyctenular Conjunctivitis and Tuberculosis

Introduction: Phlyctenular keratoconjunctivitis is a nodular affliction characterized by the formation of a small, circumscribed lesion at the corneal limbus and now accepted as a morphologic expression of delayed hypersensitivity to diverse antigens. The condition is one of several corneal disorders that arise as an expression of altered immune mechanisms [4]. Materials and Methods: A 2.5 years old male child presented with a history of watering and redness from his left eye since 3-4 days. On ocular examination, an elevated nodule of approximately 2x1 mm in size with central erosion at 1‘0 clock and of size 1x1 mm was present at 6:0 clock position at the limbus. History of ATT intake in the mother for a period of 6 months, at 1 year of age, was present. Monteux was 25x26 mm (Figure 3), ESR was 34mm in 1st hour, chest radiograph revealed perihilar shadows. Results: Child was put on Antitubercular therapy in the form of rifampicin (10mg/kg/day), isoniazid (10mg/kg/day), pyrazinamide (25mg/kg/day) for 2 months (2HRZ) and isoniazid and rifampicin for another 4 months (4HR). Phlyctens resolved after a follow up of 1 month. Conclusion: Phlyctenular keratoconjunctivitis should be evaluated for tuberculosis and with a positive test, should be referred for tuberculosis therapy