Primary Bilateral Tuberculous Dacryocystitis with Preauricular Lymphadenopathy: A Diagnostic Difficulty of Recent Times

Abstract

Primary tuberculous dacryocystitis as an entity is not mentioned in recent standard ophthalmology textbooks 1 owing to the paucity of case reports in the English-language literature for the past 3 decades. We present the rare case of an otherwise healthy woman with bilateral tuberculous dacryocystitis along with preauricular lymphadenopathy; no other tuberculous lesion was discovered on her body. The clinical presentation resembled that of chronic bacterial dacryocystitis. Diagnosis was made postoperatively on histopathologic examination of the lacrimal sac wall. The patient underwent antitubercular treatment (ATT), which was successful, and bilateral endonasal endoscopic dacryocystorhinostomy.

Tubercular Dacryocystitis: A Quirky Diagnosis!!

“…As the reports in literature suggest, all the cases of tubercular dacryocystitis were established either in the presence of overlying skin involvement or on extensive search for tuberculosis in adnexa for repeated failure of lacrimal drainage surgeries. [3][4][5][6] In our case, the presence of swelling in the medial canthal region prompted us to get a CT scan done to rule out the presence of agger nasi that may be compressing the sac drainage or a spaceoccupying lesion in the sac. The finding of mass in the lacrimal sac impelled us to take a biopsy and thereby arrive at a diagnosis which was corroborated by positive Mantoux test and raised ESR.…”

An unusual case of tuberculous dacryocystitis

“…We describe an unusual case of tuberculous (TB) dacryocystitis, a rare secondary cause of nasolacrimal duct obstruction, 3,4 diagnosed with the aid of out-patient nasal endoscopy.…”