ArticleBMJ case reports2025
Tubercular osteomyelitis masquerading as acute dacryoadenitis.
Article in BMJ case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
A girl in her second decade of life presented with a painful, progressively increasing S-shaped swelling of the right upper lid, suggestive of acute dacryoadenitis. She had a history of close contact with a tuberculosis (TB) patient. Despite improvement in preseptal cellulitis with broad-spectrum (non-tubercular) systemic antibiotics, a fluctuant swelling persisted. After resolution of preseptal cellulitis, a CT scan revealed possible tubercular osteomyelitis of the lateral orbital wall and a cold abscess in the right orbit. Ultrasonography-guided drainage of the abscess was performed, and the sample tested positive for Cartridge-based Nucleic Acid Amplification Test, confirming TB. The patient was started on antituberculosis treatment, leading to complete resolution of the swelling with no recurrence during a 2-year follow-up. This case emphasises the importance of maintaining a high index of suspicion for TB in cases of dacryoadenitis unresponsive to antibiotics, especially in endemic regions like India.
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