DR. SHREYANGSI BISWAS

DR.KALISHANKAR DAS

Abstract

A C/O CILIARY STAPHYLOMA IN 3 MNTH CHILD WITH CBNAAT +VE FOR AFR.PATIENT P/W H/O FEVER FOR 1.5 MONTH A/W GRADUAL LF EYE ENLARGEMENT & REDNESS.CILIARY STAPHYLOMA WITH SCLERAL ABCESS,AC HYPOPYON FOUND.CORNEA EDEMATOUS WITH CONJUNCTIVAL CONGESTION.

INVESTIGATION:

USG B SCAN:MEMBRANOUS ECHOES IN VITREOUS

CECT ABDOMEN: MOD HEPATOMEGALY.MILD SPLEENOMEGALY WITH MULTIPLE HYPODENSE LESION-? METASTASIS/ SEPTIC EMBOLI

CECT THORAX: MULTIPLE NODULAR LESIONS B/L, S/O METASTASIS/ SEPTIC EMBOLI

PATIENT GIVEN SYSTEMIC & INTRAVITREAL ANTIBIOTICS, TOPICAL E/D

EYE DID NOT IMPROVE;AGGRAVATED TO SCLERAL ABCESS WITHIN 3-4 DAYS.CBNAAT WAS +VE FOR AFB. ATD WAS INITIATED.PATIENT DRAMATICALLY RESPONDED. USG B SCAN REVEALED ECHOFREE VITREOUS

CONCLUSION:THOUGH RARE IN CHILDREN; INDIA BEING AN ENDEMIC ZONE OF TB, CBNAAT AND OTHER SPECIFIC TEST FOR TB IS PIVOTAL IN SUCH CASES WITH SCLERITIS AND ANT SEGMENT INFLAMMATION ASAP TO PREVENT PERMANENT OCULAR DAMAGE.