Case Report: Ocular Tissue Diagnosis of Previously Undiagnosed, Extensively Drug-Resistant Pulmonary Tuberculosis

Soumyava Basu Uveitis Service, LV Prasad Eye Institute, Hyderabad, India;

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Somasheila I. Murthy Uveitis Service, LV Prasad Eye Institute, Hyderabad, India;
The Cornea Institute, LV Prasad Eye Institute, Hyderabad, India;

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Sanchita Mitra Jhaveri Microbiology Laboratory, LV Prasad Eye Institute, Hyderabad, India;

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Sumalatha Chittiboyina State TB Training and Demonstration Centre, Hyderabad, India;

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Sivakumar Shanmugham Bacteriology Division, National Institute of Research in Tuberculosis, Chennai, India

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ABSTRACT.

We describe a patient with concurrent ocular and pulmonary tuberculosis (TB) in whom the diagnosis of extensively drug-resistant TB was made through phenotypic drug-sensitivity testing of an ocular fluid sample after sputum testing yielded incomplete results. Our results are remarkable, because culture-based diagnosis of TB in ocular fluid is unusual. We not only overcame this limitation, but also were able to create a complete drug-sensitivity testing profile from ocular samples, which led to effecting appropriate therapy for the patient.

Author Notes

Address correspondence to Soumyava Basu, Prof Brien Holden Eye Research Center, LV Prasad Eye Institute, Kalam Anji Reddy Campus, Hyderabad, India. E-mail: basu@lvpei.org

Financial support: This work was supported by the Hyderabad Eye Research Foundation.

Authors’ addresses: Soumyava Basu, Uveitis Service, LV Prasad Eye Institute, Hyderabad, India, E-mail: basu@lvpei.org. Somasheila I. Murthy, Uveitis Service, LV Prasad Eye Institute, Hyderabad, India, and The Cornea Institute, LV Prasad Eye Institute, Hyderabad, India, E-mail: smurthy@lvpei.org. Sanchita Mitra, Jhaveri Microbiology Laboratory, LV Prasad Eye Institute, Hyderabad, India, E-mail: sanchita.mitra@lvpei.org. Sumalatha Chittiboyina, State TB Training and Demonstration Centre, Hyderabad, India, E-mail: stdcepidemiologist@gmail.com. Sivakumar Shanmugham, Bacteriology Division, National Institute of Research in Tuberculosis, Chennai, India, E-mail: shanmugamsiva27@gmail.com.

  • 1.

    Wroblewski KJ , Hidayat AA , Neafie RC , Rao NA , Zapor M , 2011. Ocular tuberculosis: a clinicopathologic and molecular study. Ophthalmology 118: 772777.

  • 2.

    Standardization of Uveitis Nomenclature (SUN) Working Group , 2021. Classification criteria for tubercular uveitis. Am J Ophthalmol 228: 142151.

  • 3.

    Kee AR et al., 2016. Anti-tubercular therapy for intraocular tuberculosis: a systematic review and meta-analysis. Surv Ophthalmol 61: 628653.

  • 4.

    Agarwal A , Marchese A , Aggarwal K , Arora A , Thattaruthody F , Sharma K , Sharma S , Sharma A , Gupta V , Basu S , 2022. Diagnostic and therapeutic challenges. Retina 42: 216223.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Bansal R et al., 2015. Detection of Mycobacterium tuberculosis genome in vitreous fluid of eyes with multifocal serpiginoid choroiditis. Ophthalmology 122: 840850.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Central TB Division , 2021. Guidelines for Programmatic Management of Drug-Resistant Tuberculosis in India. Available at: https://www.tbcindia.nic.in/WriteReadData/l892s/8368587497Guidelines%20for%20PMDT%20in%20India.pdf. Accessed October 2, 2022.

    • PubMed
    • Export Citation
  • 7.

    Gilpin C , Korobitsyn A , Weyer K , 2016. Current tools available for the diagnosis of drug-resistant tuberculosis. Ther Adv Infect Dis 3: 145151.

  • 8.

    World Health Organization , 2021. WHO Announces Updated Definitions of Extensively Drug-Resistant Tuberculosis. Available at: www.who.int/news/item/27-01-2021-who-announces-updated-definitions-of-extensively-drug-resistant-tuberculosis. Accessed July 17, 2022.

    • PubMed
    • Export Citation
  • 9.

    World Health Organization , 2021. Global Tuberculosis Report 2021. Available at: https://www.who.int/publications/i/item/9789240037021. Accessed July 17, 2022.

    • PubMed
    • Export Citation
  • 10.

    Alagna R , Cabibbe AM , Miotto P , Saluzzo F , Köser CU , Niemann S , Gagneux S , Rodrigues C , Rancoita PVM , Cirillo DM , 2021. Is the new WHO definition of extensively drug-resistant tuberculosis easy to apply in practice? Eur Respir J 58: 2100959.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Viney K , Linh NN , Gegia M , Zignol M , Glaziou P , Ismail N , Kasaeva T , Mirzayev F , 2021. New definitions of pre-extensively and extensively drug-resistant tuberculosis: update from the World Health Organization. Eur Respir J 57: 2100361.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Norbis L , Alagna R , Tortoli E , Codecasa LR , Migliori GB , Cirillo DM , 2014. Challenges and perspectives in the diagnosis of extrapulmonary tuberculosis. Expert Rev Anti Infect Ther 12: 633647.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Desai U , Joshi JM , 2019. Extrapulmonary drug-resistant tuberculosis at a drug-resistant tuberculosis center, Mumbai: our experience: hope in the midst of despair! Lung India 36: 37.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Diriba G , Tola HH , Alemu A , Yenew B , Gamtesa DF , Kebede A , 2021. Drug resistance and its risk factors among extrapulmonary tuberculosis in Ethiopia: a systematic review and meta-analysis. PLoS One 16: e0258295.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Biswas J , Madhavan HN , Gopal L , Badrinath SS , 1995. Intraocular tuberculosis: clinicopathologic study of five cases. Retina 15: 461468.

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