Arch Craniofac Surg.  2019 Aug;20(4):274-278. 10.7181/acfs.2019.00339.

Primary orbital tuberculosis on the lower eyelid with cold abscess

Affiliations
  • 1Department of Plastic and Reconstructive Surgery, Wonkwang University Hospital, Iksan, Korea. ycnadr@hanmail.net
  • 2Leehyemi Plastic Surgery Clinic, Gwangju, Korea.

Abstract

Orbital tuberculosis is a rare form of extrapulmonary tuberculosis, even in endemic areas. It may involve the soft tissue, lacrimal gland, periosteum, or bones of the orbital wall. We present a case of orbital tuberculosis on the lower eyelid. An 18-year-old woman with no underlying disease visited our clinic for evaluation of an oval nodule (1.5× 1.2 cm) on the right lower eyelid. Incision and drainage without biopsy was performed 2 months ago in ophthalmology department, but the periorbital mass had deteriorated, as the patient had erythematous swelling, tenderness, and cervical lymphadenopathy. Visual acuity was normal; there were no signs of proptosis, diplopia, or ophthalmoplegia. Computed tomography revealed a small abscess cavity without bony involvement. We performed an excision and biopsy through a percutaneous incision under local anesthesia. Histological examination revealed a granuloma and was diagnosed as orbital tuberculosis. The patient was additionally treated with anti-tuberculosis therapy for 6 months and recovered without complication or recurrence by 7 months. Orbital tuberculosis occurs in patients with or without associated pulmonary tuberculosis, and should be considered as a differential diagnosis in patients with inflammatory orbital disease and an orbital mass. If recurrence occurs despite adequate initial treatment, we recommend an additional examination and excisional biopsy.

Keyword

Abscess; Eyelid; Orbit; Tuberculosis

MeSH Terms

Abscess*
Adolescent
Anesthesia, Local
Biopsy
Diagnosis, Differential
Diplopia
Drainage
Exophthalmos
Eyelids*
Female
Granuloma
Humans
Lacrimal Apparatus
Lymphatic Diseases
Ophthalmology
Ophthalmoplegia
Orbit*
Orbital Diseases
Periosteum
Recurrence
Tuberculosis*
Tuberculosis, Pulmonary
Visual Acuity
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