conjunctival tuberculosis
Introduction
Introduction to conjunctival tuberculosis Conjunctival tuberculosis (tuberculosis of the conjunctiva) is a conjunctival inflammation caused by infection with Mycobacterium tuberculosis, which is relatively rare in clinical practice. It is divided into two types, primary and secondary, but it is not easy to distinguish clinically. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of transmission: spread through secretions Complications: tuberculosis, renal tuberculosis, bone tuberculosis, abscess
Cause
Causes of conjunctival tuberculosis
(1) Causes of the disease
Mycobacterium tuberculosis Gram staining is generally not easy to color, acid-fast staining is red, the primary infection refers to the patient has never suffered from tuberculosis, tuberculosis through the patient's secretions, dust or foreign bodies directly into the conjunctival sac caused by conjunctival tuberculosis Infection, occurs in the lower sulcus of the upper epiphysis, and is often accompanied by caseous necrosis of the anterior and submandibular lymph nodes. Secondary infection refers to tuberculosis in other parts of the patient's body. The patient carries the tuberculosis to the conjunctiva by hand or utensil. , or directly spread by adjacent tissues, can also spread to the conjunctiva via the blood line, leading to conjunctival infection, secondary infection generally does not affect the local lymph nodes.
(two) pathogenesis
Tuberculosis is often a chronic process in the clinic. It is often affected by the body's reactivity, immune status and treatment measures. The pathological changes are complicated. Depending on the number of infected tubercle bacilli, the virulence can resist the killing of macrophages. The elimination depends on the balance between the protective immune response and the pathological immune response of the body and various genetic factors of the host. The basic pathological changes are exudative lesions, proliferative lesions and caseous necrosis. Pathological changes can be transformed into each other, staggered, and one of the main lesions, there may be non-specific inflammatory lesions.
Prevention
Conjunctival tuberculosis prevention
It is necessary to start from the control of the source of infection, cut off the route of transmission and enhance immunity, reduce susceptibility, and timely vaccination with BCG.
Complication
Conjunctival tuberculosis complications Complications, tuberculosis, kidney tuberculosis, tuberculosis abscess
Tuberculosis, kidney tuberculosis, bone tuberculosis, and cold abscesses in internal organs.
Symptom
Conjunctival tuberculosis symptoms common symptoms purulent secretion nodular congestion blood polyps
The affected eye may have swelling of the eyelids, purulent secretions, and often no pain. Therefore, patients often cannot see the doctor in time. According to the patient's immunity to Mycobacterium tuberculosis, the lesions can be expressed in the following types:
1. Ulcer type occurs mostly in the sacral conjunctiva, and sometimes in the bulbar conjunctiva, which is characterized by single or several scattered miliary ulcers. The surface of the ulcer is a proliferating granulation tissue. The ulcer is a chronic process. Expansion, severe cases can involve the cornea, sclera, and even invade the entire layer of the eyelid, tuberculosis can be found in the scraper at the bottom of the ulcer.
2. Nodular yellow nodules appear under the nodular conjunctiva, gradually increasing, showing a granular bulge, no rupture on the surface, surrounded by follicular or granulation tissue, the disease progresses slowly, and eventually develops into a cauliflower-like shape. Necrotic area.
3. The papillary hyperplasia occurs mostly in the conjunctiva of the Qianlong, and can also be seen in the sacral conjunctiva. The lesion is a proliferating granulation tissue. The gingival process occurs in the Qianlong area, which is a gel-like hyperplasia, resembling a cockroach-like scorpion, with shallow ulcers on the surface.
4. Polyps occur mostly in the sacral conjunctiva, shaped like a pedicled fibroid.
5. The tuberculosis type may be metastatic tuberculosis. There is a single, hard, yellow or yellow-red under the conjunctiva. The soy-like nodules are soy-sized, the surface epithelium is intact, no ulcer is formed, and the base is often adhered to the sclera. Can not move.
6. Conjunctival tuberculosis tissue lesions are the same as miliary tuberculosis. There are rash-like nodules on the bulbar conjunctiva, about 1mm, no congestion around, and spontaneous disappearance. According to typical conjunctival lesions, combined with medical history, conjunctival scraping or biopsy, combined with special staining and pathological examination of Mycobacterium tuberculosis can confirm the diagnosis.
Examine
Conjunctival tuberculosis examination
1. Take the conjunctival scraping combined with the special staining of Mycobacterium tuberculosis to determine the pathogen.
2. Pathological examination can reveal three typical tuberculous pathological changes in the tissue.
3. Imaging examination: It can detect the infection of tuberculosis in other parts of the body.
Diagnosis
Diagnosis and diagnosis of conjunctival tuberculosis
Identification with other chronic conjunctivitis depends on the diagnosis of pathogens.
