Tuberculosis presenting as dacryoadenitis in the USA

• Published in: BMJ case reports Vol. 12; no. 11; p. e231694
• Main Authors: Powers, Harry Ross, Diaz, Mark Anthony, Mendez, Julio C
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 19.11.2019; BMJ Publishing Group
• Series: Case report
• Subjects: Adult; Antitubercular Agents - therapeutic use; Biopsy; Case reports; Dacryocystitis - diagnosis; Dacryocystitis - microbiology; Eye diseases; Family medical history; Female; Granuloma - pathology; HIV; Human immunodeficiency virus; Humans; Infections; Inflammation; Lacrimal Apparatus - microbiology; Lacrimal Apparatus - pathology; Meningitis; Mycobacterium tuberculosis - isolation & purification; Orbital Diseases - microbiology; Orbital Diseases - pathology; Pain; Patients; Rare Disease; Systematic review; Treatment Outcome; Tuberculosis; Tuberculosis, Ocular - drug therapy; United Kingdom > UK; United States > US; Philippines; TB and other respiratory infections; ophthalmology
• ISSN: 1757-790X; 1757-790X
• DOI: 10.1136/bcr-2019-231694

A 25-year-old Filipino woman living in the USA was evaluated for a 5-month history of left eye pain and a subsequent orbital mass. Histopathological analysis of the lacrimal mass showed a mixed inflammatory process with necrotising granulomas and positive cultures for Mycobacterium tuberculosis. She was treated with antituberculosis therapy, with resolution of symptoms. Tuberculosis dacryoadenitis is extremely rare in the USA and other developed countries. It requires a high degree of clinical suspicion with special attention to the patient’s history to make the correct diagnosis. It can be treated successfully with antituberculosis therapy.