DR. ANUPAM SINGH

DR.HARIKA REGANI, DR. ARPAN GANDHI, DR. NIDHI TOMAR

Abstract

A 15 year old female presented with the right eye lower eyelid swelling since 8 months. On examination, there was an inferolateral inflamed mass with subtle fullness in the temporal fossa. There was no history of fever or loss of weight or appetite. The consecutive radiological imaging within a 3 month period revealed an orbital mass which has progressed from superolateral orbit with bulky lacrimal gland to the inferior orbital margin with associated lateral orbital wall destruction. Intraoperatively, a thick pus was extruded from the incision site which was sent for the microbiological evaluation. Gram positive cocci was isolated on staining. Meanwhile, Mantoux test was highly positive. 15 days later, mycobacterium tuberculosis was isolated on Lowenstein-Jensen media. This case highlights the importance of culture which was crucial in management. The patient was started on antituberculosis therapy as per Index-TB guidelines and is doing well since 3 months of treatment.