Bilateral ocular scrofuloderma with orbital tuberculosis

Abstract

Ocular scrofuloderma with orbital tuberculosis is a rarely described presentation of childhood tuberculosis. Bilateral involvement has not been reported earlier in the medical literature. Here is reported a 3-year-old boy who presented with bilateral infraorbital swellings of tubercular etiology. Computed tomography (CT) scan of the upper face revealed enhancing soft tissue lesions in both the lower lids of the eyes, with extraconal extension into the orbits and with erosion of the right zygomatic bone. Tubercular etiology was confirmed by the Ziehl Neelsen staining of the aspirate from the lesion, which was positive for acid-fast bacilli and growth of Mycobacterium tuberculosis in the aspirate culture. The patient showed marked improvement of his lesions on anti-tubercular treatment.

Tuberculosis: An Extremely Unusual Cause of Orbital Wall Erosion

“…Tubercular osteomyelitis is more commonly seen in children and young adults, as in our patient. The clinical presentation is usually in the form of a swelling or a sinus in the periorbital region with or without involvement of the intra-orbital contents (Sethi et al, 2006;Sharma et al, 2006).…”

Orbital Tuberculosis with Intracranial Extension

“…Orbital involvement by tuberculosis may be in primary or secondary form. [ 3 ] In secondary ocular tuberculosis, infection results either from contiguous spread from adjacent structures or by the hematogenous route. [ 4 ] Intracranial extension of orbital tuberculoma is extremely rare, and it may occur in the form of extradural abscess and infra-temporal fossa extension.…”

Scrofuloderma and bilateral anterior staphyloma of eye: An unusual association

“…It often occurs in children and patients with low immunity and involves most commonly the lymph nodes of the cervical region. There have been reports of ocular scrofuloderma with unilateral4 as well as bilateral5 orbital tuberculosis presenting with proptosis.…”

“…Ocular involvement is well described in association with cutaneous tuberculosis; most reports documented are phlyctenular keratoconjunctivitis, tarsitis, and orbital tuberculosis 3. Ocular scrofuloderma with orbital involvement has been previously described 45. However, to the best of our knowledge, no case of bilateral simultaneous symmetrical multiple corneal ulceration with perforation has been reported in the English peer review literature.…”