A 11 year old female was referred from ophthalmology clinic to pulmonary medicine department for further evaluation of a case of unilateral conjunctivitis not responding to treatment as suspected case of conjuctival tuberculosis. In the right eye, bulbar conjunctiva in supranasal quadrant polypoidal appearance was seen and there was subconjunctival cystic nodular mass in the superior conjunctival fornix. Systemic examination was unremarkable. Microbiological and histopathological examination of excision biopsy of the subconjunctival cyst revealed a granulomatous inflammation but acid fast bacilli was negative. Tissue sample was subjected to CBNAAT (Cartridge based nucleic acid amplification technique) examination in which mycobacterium tuberculosis was detected and sensitive to rifampicin. Patient was started on anti tuberculosis treatment under NTEP (national tuberculosis elimination programme) and full remission was achieved with 6 months of anti tuberculosis treatment. Although primary tuberculous conjunctivitis is a very rare condition, it should be considered in the differential diagnosis of treatment-resistant unilateral conjunctivitis. For definitive diagnosis, microbiological, histopathological and molecular examinations should be performed in conjunctival samples.
Introduction- Non-resolving pneumonia is always a challenging clinical scenerio where Various diagnostic modalities are greatly required to reach the diagnosis. We aimed to study The role of beroptic bronchoscopy in non-resolving pneumonia along with the various comorbidities associated with the disease condition. Methodology- A prospective observative study in a tertiary care hospital was undertaken. A total of 40 patients diagnosed with non-resolving pneumonia were recruited for diagnostic beroptic bronchoscopy. Results- The overall diagnostic yield of beroptic bronchoscopy in non-resolving pneumonia was 87.5%. The causes of non-resolving pneumonia were Tuberculosis(22.5%), bacterial pneumonia(45%), malignancy(15%), fungal pneumonia(5%). 12.5% patients were undiagnosed. Patients had a signicant past history which also revealed associated comorbid conditions. Diabetes(14(33%)) and COPD(11(27.5%)) were leading comorbid conditions. Conclusion- Fiberoptic Bronchoscopy is a great utility tool in reaching the diagnosis in patients with non-resolving pneumonia.
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