Introduction

Tuberculosis is considered an Occupational Disease in Health Care Professionals and can have pulmonary manifestations or, more rarely, extrapulmonary manifestations, such as Ocular Tuberculosis, which can manifest in different ways. According to the Direção Geral de Saúde, Health Institutions should adopt early detection measures and considers that cases of active Tuberculosis in Health Care Professionals should be considered as an Occupational Disease.

Case Report

Technical Assistant, 57 years old, in the Physical Medicine and Hospital Rehabilitation service, with a history of recurrent episcleritis in the left eye for one year. She is observed by Ophthalmology and Internal Medicine. No other major complaints or background. She had a positive Mantoux test and a positive Interferon Gamma Release Assay test in a patient already medicated with oral and local corticosteroids, without improvement. It was assumed that it would be Ocular Tuberculosis, despite not being a typical presentation of the disease, but given the recurrence and treatment failure, it was decided to start treatment for Tuberculosis as active disease, with total remission of complaints. Given the occupational exposure, this case was reported as a suspicion of Occupational Illness and she was removed from her workplace until treatment was completed.

Discussion

Tuberculosis is one of the most important Occupational Diseases in Health Professionals. As an extrapulmonary manifestation, ocular tuberculosis is rare, but it can have strong implications for the patient's health. Contrary to what has been observed with other occupational infectious diseases, the incidence of Tuberculosis has been increasing, so it is recommended to screen the risk groups. If there is suspicion, the Occupational Physician must remove the worker from the workplace, notify and report the suspicion of occupational disease.

Early diagnosis can be difficult, due to the diversity of presentation, and constitutes a considerable clinical challenge, being often a presumptive diagnosis and the basic principles of treatment for extrapulmonary tuberculosis are common to pulmonary tuberculosis.

Conclusion

Ocular Tuberculosis as a disease presentation is rare and in Health Care Professionals it is an Occupational Disease given the risk of exposure. Occupational Disease participation by Occupational Medicine took into account the workplace and the risks, showing us the importance of correctly analyzing the place and working conditions, as well as the screening, prevention and infection control measures.

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