Orbital tuberculosis: a case report and update on the role of imaging in treatment

ABSTRACT

Orbital tuberculosis is a manifestation of extra-pulmonary tuberculosis that is challenging to diagnose and treat. Here, we describe the pivotal role of serial imaging in the diagnosis and treatment of orbital tuberculosis. A 28-year-old male presented with recurrent right upper eyelid swelling and a supraduction deficit associated with a firm painless orbital mass, seen on initial computed tomography to be an extensive superomedial lesion producing mass effect. Biopsy revealed a tuberculosis-like granulomatous inflammation, which, coupled with a positive QuantiFERON gold test, led to empiric anti-tuberculin treatment. Serial radiologic imaging following initiation of treatment showed progressive reduction in mass size, supporting the diagnosis and determining the length of treatment. This rare case demonstrates the utility of serial radiologic exams in the diagnosis and treatment of orbital tuberculosis.

KEYWORDS:

• Diagnosis
• imaging
• orbital tuberculosis

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Proprietary interest statement

Bryan Winn is a consultant for Viridian. Lora Dagi Glass receives royalties from Thieme publishers.

Additional information

Funding

The Department of Ophthalmology at Columbia University Irving Medical Center is supported by an unrestricted grant from Research to Prevent Blindness.