Costal tubercular osteomyelitis presenting as an orbital abscess

Area of Science:

• Infectious Diseases
• Radiology
• Pulmonology

Background:

• Orbital abscesses typically link to paranasal sinus infections.
• Costal tuberculosis (TB), a rare extrapulmonary skeletal TB, presents diagnostic challenges.
• Orbital abscess as an initial manifestation of remote costal TB is exceptionally rare.

Purpose of the Study:

• To report an unusual case of orbital abscess secondary to costal tubercular osteomyelitis.
• To emphasize the diagnostic difficulties and rare presentation of extrapulmonary TB.
• To highlight the importance of clinicoradiological assessment in diagnosing remote TB.

Main Methods:

• Case report analysis.
• Review of clinicoradiological findings.
• Treatment with standard first-line anti-tubercular therapy (ATT).

Main Results:

• An immunocompetent patient presented with an orbital abscess without sinus pathology.
• Costal tubercular osteomyelitis and an anterior chest wall abscess were diagnosed.
• The patient responded well to ATT.

Conclusions:

• Orbital abscess can be an atypical initial presentation of disseminated tuberculosis.
• Prompt diagnosis and appropriate anti-tubercular therapy are essential for managing such rare cases.
• Clincoradiological correlation is vital for suspecting TB in extrapulmonary sites.