Background: Mycobacterial tuberculosis is a multisystem infection that can affect nearly any organ. We report a case of tuberculous neuroretinitis in an otherwise healthy man from Honduras with negative Tuberculin Skin Test and Quantiferon Tuberculosis Gold tests.
Case Report: A 26-year-old man from Honduras presented with acute painless loss of vision in his left eye for 5 days. Ophthalmic examination was remarkable for decreased visual acuity in the left eye. The patient was admitted and treated with intravenous steroids for suspected retinal vasculitis. Computed tomographic scans of the brain and the orbit were unremarkable. A computed tomographic scan of the chest showed a right apical nodule. Acid-fast stains, tuberculin skin test, and Quantiferon testing all returned negative. Biopsy of the lung nodule confirmed the diagnosis of Mycobacterium tuberculosis neuroretinitis.
Conclusion: Our case illustrates the importance of pursuing a diagnosis when clinical suspicion is high, even in the absence of supportive laboratory findings