Case report -orbital tubercular dacryoadenitis

A 18-year-old male patient presented with a history of painless, progressive swelling on the left side of the face of 3 months duration. On examination, fullness along the right lateral orbital rim with ptosis (especially laterally) Ocular movement was normal. His BCVA was 6/6 in both eyes. ]. A firm, non-tender mass was palpated in the temporal orbit. There was no associated discharge or redness, and the mass was not warm or fluctuant. Slit lamp, fundus and intraocular pressure evaluations were normal in both eyes. Computed tomography (CT) of the orbits revealed a well-defined lytic lesion along the lateral orbital wall with central sequestrum and associated. Background: Orbital tuberculosis is rare even in endemic areas. The disease may involve soft tissue, lacrimal gland, or the periosteum or bones of the orbital wall. Case: We present an Indian male, who presented with a slowly growing right-sided inferolateral orbital mass, with no significant previous medical history. A tuberculin skin test was strongly positive. Incisional biopsy showed caseating granuloma and Langhan’s giant cells suggestive of tubercular aetiology. The patient responded well to tuberculous chemotherapy. Conclusion: Although tuberculous dacryoadenitis is a very rare manifestation of tuberculosis,still the possibility should be entertained in a slowly growing mass of the lacrimal gland, especially in developing countries where the prevalence of tuberculosis is high.

Nishant Vardhan and Mandeep Tomar
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Int J Inf Res Rev
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