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Tuberculous Osteomyelitis of Orbit- A Case Report
Summary
Orbital tuberculosis is a rare condition. This case highlights osteomyelitis of orbital bone in an Indian child, emphasizing early diagnosis and treatment for better outcomes in extrapulmonary tuberculosis.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Pediatric Osteomyelitis
Background:
- Orbital tuberculosis is an uncommon presentation of extrapulmonary tuberculosis.
- This report details a rare case of orbital bone osteomyelitis in a pediatric patient.
Observation:
- A 9-year-old girl presented with a two-month history of painless left upper eyelid swelling, ptosis, and forehead swelling.
- Initial abscess drainage yielded sterile pus; however, clinical signs, a positive Mantoux test, elevated ESR, and CECT findings confirmed orbital osteomyelitis and infratemporal fossa abscess.
- A sinus tract developed post-treatment, requiring surgical excision and debridement.
Findings:
- The patient showed significant improvement with antitubercular drug (ATD) therapy.
- Histopathological and microbiological examination of excised sinus tissue was performed.
- A 15-month course of ATD resulted in no recurrence during a three-year follow-up.
Implications:
- A high index of suspicion is crucial for the early diagnosis of orbital tuberculosis.
- Timely and appropriate treatment, including antitubercular drugs, is essential for managing this rare condition.
- This case underscores the importance of considering tuberculosis in pediatric orbital infections with atypical presentations.