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[Tuberculous dacryocystitis]

J B Cotton1, P Ligeon-Ligeonnet, A Durra

  • 1Service de pédiatrie, centre hospitalier de Valence, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|February 1, 1995
PubMed
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Tuberculosis rarely causes acute dacryocystitis in children. This case highlights the diagnostic challenges and successful treatment of a rare tuberculous dacryocystitis infection.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Pediatrics

Background:

  • Acute dacryocystitis, an infection of the nasolacrimal sac, can complicate congenital nasolacrimal duct obstruction.
  • While uncommon in older children, tuberculosis is an exceptionally rare cause of acute dacryocystitis.

Observation:

  • A 4 1/2-year-old boy presented with acute left dacryocystitis, fever, and cervical adenitis.
  • Lacrimal gland and lymph node involvement persisted despite antibiotic and corticosteroid treatment.
  • Lymph node biopsy confirmed Mycobacterium tuberculosis, and the patient's father had pulmonary tuberculosis.

Findings:

  • The patient received a 9-month course of isoniazid and rifampin, plus 2 months of pyrazinamide.
  • Surgical intervention, including sac drainage and dacryocystorhinostomy, was required.

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  • Diagnosis was supported by a positive tuberculin skin test.

    • Implications:

    • This rare case underscores the diagnostic complexities of tuberculous dacryocystitis in pediatric patients.
    • Effective management requires a high index of suspicion for tuberculosis in persistent or atypical cases.
    • Ophthalmologic therapy for this condition presents unique challenges, necessitating a multidisciplinary approach.