Left Eye Ocular Tuberculosis in an Immunocompromised Patient: A Diagnostic Dilemma

This case report discusses a 46-year-old male patient with a history of recurrent tuberculosis (TB) and human immunodeficiency virus (HIV), who presented with progressive left eye blurring of vision over two weeks, with eye redness and pain while hospitalized for disseminated cutaneous sporotrichosis.Initial investigations revealed a positive cytomegalovirus polymerase chain reaction test (CMV PCR) and tuberculin test, leading to a diagnosis of left eye CMV retinitis.Despite treatment with IV ganciclovir, the patient's ocular condition worsened, prompting a revised diagnosis of presumed ocular TB (OTB).The patient was started on intensive anti-TB therapy (ATT), and rapid regression of the choroidal lesion size and vitritis was observed two weeks after the commencement of ATT.The case highlights the diagnostic challenges and management complexities in patients with coexisting infections.