FP1316 : TUBERCULAR OSTEOMYLITIS – A RARE CAUSE OF PROPTOSIS

Dr.AMAN GAUR, G20405

5-yr-old healthy child presented with painless proptosis, lid swelling & mild ptosis for 5 days in LE. History of fever on & off and post auricular abscess requiring multiple drainage for past 1 month. Visual acuity was 6/9 in LE with limited abduction. Anterior segment and fundus were WNL. No systemic abnormality was found with normal ear examination except fullness & tenderness over mastoid region. Investigations for TB were negative. MRI showed left sided mastoiditis, osteomyelitis involving left squamous temporal bone & floor of middle cranial fossa with normal brain study. Patient was started on iv antibiotics with no improvement for 2 weeks. Biopsy of post aural granulation tissue was suggestive of tubercular etiology. ATT was started with resolution in signs and symptoms.

Tubercular osteomyelitis is a rare cause of proptosis. In case of non-inflammatory proptosis, diagnosis of tubercular cold abscess should be considered especially in TB endemic areas.