Purpose:

To describe that the eye, after healing its active infectious stage, reacts similarly against several systemic infectious processes that affect its structures, such as tuberculosis, Ebola, or AIDS (together with its opportunist infections).

Case report:

We report the case of a female patient that, after a successful treatment against ocular tuberculosis, developed a multifocal choroiditis due to delayed hypersensitivity, with more potential devastating effects than the active infection itself: inflammation of choroidal and retinal vessels, papillitis, and macular edema that, without treatment, may induce severe visual loss. The patient received short-term systemic corticosteroids and long-term maintenance with systemic immunosuppressants.

Conclusions:

Ocular inflammatory reactions due to hypersensitivity are more destructive than the direct infection by different pathogens since there may be an inflammatory reaction secondary to the immune recognition of infectious antigenic particles in the ocular structures. Treatment is based on verifying that the active infection has been controlled and, subsequently, initiating systemic corticoids or corticosteroid-sparing immunosuppressive agents.

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