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Bilateral ocular scrofuloderma with orbital tuberculosis.

Suvasini Sharma1, Monica Juneja, Ravindra Kumar Saran

  • 1Department of Pediatrics Pathology, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India. suvasinisharma@rediffmail.com

Indian Journal of Pediatrics
|July 4, 2006
PubMed
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This case report details a rare instance of bilateral ocular scrofuloderma in a child, a presentation previously undocumented. Early diagnosis and anti-tubercular treatment led to significant improvement in the patient

Area of Science:

  • Ophthalmology
  • Pediatrics
  • Infectious Diseases

Background:

  • Ocular scrofuloderma, a manifestation of tuberculosis (TB) affecting the eyes, is uncommon in children.
  • Bilateral involvement in ocular scrofuloderma has not been previously documented in medical literature.
  • Childhood tuberculosis requires vigilant diagnosis and management due to its varied presentations.

Observation:

  • A 3-year-old boy presented with bilateral infraorbital swellings.
  • Computed tomography (CT) scan revealed enhancing soft tissue lesions in both lower eyelids with extraconal orbital extension and right zygomatic bone erosion.
  • Clinical presentation suggested a tubercular etiology.

Findings:

  • Ziehl Neelsen staining of lesion aspirate confirmed acid-fast bacilli.

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  • Culture of the aspirate yielded growth of Mycobacterium tuberculosis, confirming tubercular etiology.
  • The patient exhibited bilateral infraorbital swellings with orbital and bony involvement.

    • Implications:

    • This case highlights the possibility of bilateral ocular scrofuloderma in pediatric tuberculosis.
    • Prompt diagnosis and initiation of anti-tubercular therapy are crucial for favorable outcomes.
    • Ophthalmologists and pediatricians should consider tuberculosis in the differential diagnosis of orbital inflammatory lesions in children.