A rare cause of blindness.

BACKGROUND: Mycobacterium tuberculosis (TB) infection remains a serious problem in many underdeveloped countries. TB is largely perceived as a disease affecting the pulmonary system, yet despite declining cases of pulmonary TB in the United States (US), extrapulmonary infections are being reported at an increasing proportion of total TB cases. Moreover, due to the insidious nature of extrapulmonary TB (EPTB), it may not be readily recognized by emergency physicians, as it masquerades as more commonly encountered infectious or inflammatory processes.

OBJECTIVES: The incidence of ocular TB infection varies widely by geographic area, but has historically been low in the US. However, a resurgence of TB in developed European nations is cause for concern, as an increasing percentage of these infections have revealed ocular involvement.

CASE REPORT: We present a case report of blindness caused by Mycobacterium tuberculosis and highlight some of the challenges the emergency physician may encounter when diagnosing EPTB. The case includes the patient's treatment course and subsequent follow-up.

CONCLUSION: Loss of vision may be a presenting complaint for active tuberculosis infection.