Orbital cold abscesses with associated pansinusitis and bone involvement

Abstract

Orbital involvement in tuberculosis is rare even in areas where TB is endemic.1 Orbital TB is classified into five forms; classical periostitis, orbital soft tissue tuberculoma or cold abscess with no bone destruction, orbital TB with bone destruction, orbital TB spread from para-nasal sinuses and tuberculous dacryoadenitis2,3,4,5. We present a 17 year old patient who presented with a third recurrence of orbital and forehead abscesses. On orbital CT-scan, the patient had pan-sinusitis, right orbital and frontal abscesses, bilateral proptosis and frontal bone destruction. Initially the diagnosis of orbital TB was based on a good response to antituberculosis medications and it was later confirmed by histology showing caseating TB granulomas.