Mycobacterium hemophilum infection presenting as filamentary keratopathy in an immunocompromised adult.
OBJECTIVE
To report a case of Mycobacterium hemophilum of the eye.


METHODS
Case report with pathologic correlation. A 55-year-old Malaysian man with a 3-year history of graft-versus-host disease presented with dry eye and keratopathy.


RESULTS
The diagnosis was not initially evident, despite biopsy specimens of the conjunctiva. Definitive diagnosis was made after dermatology consultation suggested a histoid variant of lepromatous leprosy, prompting Ziehl-Neelsen staining of the initial and subsequent conjunctival biopsies with subsequent polymerase chain reaction testing. Anti-M. hemophilum treatment resulted in prompt resolution of ocular signs.


CONCLUSIONS
Mycobacterium hemophilum is a rare condition, affecting mainly immunocompromised patients. Although filamentary keratopathy has been described as common manifestations of leprosy, to date, no ocular manifestations of M. hemophilum have been described. Conjoint management with infectious disease and clinical microbiology is imperative to ensure accurate diagnosis and appropriate early intervention. The effect of systemic immunosuppression is relevant in such patients.
Millar
Michael James
MJ
Department of Ophthalmology, Westmead Hospital, New South Wales, Australia.
Bulliard
Carl
C
Balachandran
Chandra
C
Maloof
Anthony J
AJ
D003229:Conjunctival Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D003316:Corneal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D015818:Eye Infections, Bacterial / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009164:Mycobacterium Infections / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D018393:Mycobacterium haemophilum / Q000302:isolation & purification*
D007166:Immunosuppressive Agents