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Bhattacharya S, Raina UK, Gupta SK, Mishra M, Saini V, Kumar B. Tubercular Osteomyelitis of the Orbit Presenting as Periorbital Cellulitis. JOVR [Internet]. 2022Jan.21 [cited 2024Apr.18];17(1):146–149. Available from: https://knepublishing.com/index.php/JOVR/article/view/10181

https://doi.org/10.18502/jovr.v17i1.10181

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authors

  • Shruti Bhattacharya

    Shruti Bhattacharya

    Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
  • Usha K Raina

    Usha K Raina

    Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
  • Shantanu K Gupta

    Shantanu K Gupta

    Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
  • Manisha Mishra

    Manisha Mishra

    Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
  • Varun Saini

    Varun Saini

    Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India
  • Brajesh Kumar

    Brajesh Kumar

    Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, India

Published Date

  • Jan 21, 2022
This journal is publishing all the articles under Creative Commons Attribution License CC BY 4.0.

Tubercular Osteomyelitis of the Orbit Presenting as Periorbital Cellulitis

Journal of Ophthalmic and Vision Research (JOVR) / January–March 2022, Volume 17, Issue 1 / Pages 146–149

Abstract

Purpose: Osteomyelitis of the orbital bones presenting as an orbital cellulitis is a rare form of extrapulmonary tuberculosis (TB). We report a rare case of tubercular osteomyelitis of the orbital bones presenting as a periorbital cellulitis.


Case Report: A seven-year-old female child presented to our tertiary eye care center with swelling involving the right eyelids and the right cheek for two months. She had been provisionally diagnosed elsewhere as pre-septal cellulitis and had been given oral antibiotics. We clinically diagnosed her as orbital cellulitis, but her non-responsiveness to intravenous antibiotics prompted us to get a contrast enhanced computed tomography (CECT) of the orbit and paranasal sinuses, which was suggestive of tubercular etiology. However, the patient had no foci for TB elsewhere. We used a relatively new, but rapid test, called Cartridge-based Nucleic Acid Amplification Test (CBNAAT) on the pus aspirate which was positive for TB. Thereafter, the patient was started on anti-tubercular treatment to which she responded wonderfully.


Conclusion: A high index of suspicion should be kept for TB infection in cases of orbital cellulitis with unusual clinical behavior in an endemic region such as India.

Keywords:

Orbital Tuberculosis, Periorbital Cellulitis, Tubercular Osteomyelitis

References
1. Shakrachi FI. Ocular tuberculosis: current perspective. Clin Ophthalmol 2015;9:2223–2227.

2. Helm CJ, Holland GN. Ocular tuberculosis. Surv Ophthalmol 1993;38:229–256.

3. Varma D, Anand S, Reddy AR, Das A, Watson JP, Currie DC, et al. Tuberculosis: an under-diagnosed aetiological agent in uveitis with an effective treatment. Eye 2006;20:1068– 1073.

4. Sen DK. Tuberculosis of the orbit and lacrimal gland: a clinical study of 14 cases. J Pediatr Ophthalmol Strabismus 1980;17:232–238.

5. Mittala R, Sharma S, Rath S, Barik MR, Tripathy D. Orbital tuberculosis: clinicopathological correlation and diagnosis using PCR in formalin-fixed tissues. Orbit 2017;36:264–272.

6. Madge SN, Prabhakaran VC, Shome D, Kim U, Honavar S, Selva D. Orbital tuberculosis: a review of the literature. Orbit 2008;27:267–277.

7. Sethi A, Sethi D, Agarwal AK, Nigam S, Gupta A. Tubercular and chronic pyogenic osteomyelitis of cranio-facial bones: a retrospective analysis. J Laryngol Otol 2008;122:799–804.

8. Lee JY. Diagnosis and treatment of extra pulmonary tuberculosis. Tuberc Respir Dis 2015;78:47–55.

9. Singh KG, Tandon S, Nagdeote ST, Sharma K, Kumar A. Role of CB-NAAT in diagnosing mycobacterial tuberculosis and rifampicin resistance in tubercular peripheral lymphadenopathy. Int J Med Res Rev 2017;5:242–246.

10. Sahana KS, Prabhu AS, Saldanha PRM. Usage of Cartridge Based Nucleic Acid Amplification Test (CBNAAT/GeneXpert) test as diagnostic modality for pediatric tuberculosis; case series from Mangalore, South India. J Clin Tuberc Other Mycobact Dis 2017;11:7–9.

11. Khalil M, Lindley S, Matouk E. Tuberculosis of the orbit. Ophthalmology 1985;92:1624–1627.