A case suspected of early active pulmonary tuberculosis detected by CT with the onset of episcleritis

A 56-year-old female with the chief complaint of conjunctival injection was referred to our hospital after treatments with oral and topical corticosteroid under the diagnosis of episcleritis without any therapeutic efficacy. Possible causes of the episcleritis such as collagen vascular disease were not found, but a chest CT revealed centrilobular nodules, branching linear lesions and bronchial wall thickening which were not detected in a plain X-ray picture. We suspected pulmonary tuberculosis and tuberculous episcleritis based on these CT findings, strongly positive tuberculine skin test result and a history of contact with a smear positive tuberculosis patient. The pulmonary lesion disappeared and the episcleritis healed after the treatment with systemic antituberculous agents.