{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T18:10:02Z","timestamp":1756318202173,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,3,25]]},"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>A girl in her second decade of life presented with a painful, progressively increasing S-shaped swelling of the right upper lid, suggestive of acute dacryoadenitis. She had a history of close contact with a tuberculosis (TB) patient. Despite improvement in preseptal cellulitis with broad-spectrum (non-tubercular) systemic antibiotics, a fluctuant swelling persisted. After resolution of preseptal cellulitis, a CT scan revealed possible tubercular osteomyelitis of the lateral orbital wall and a cold abscess in the right orbit. Ultrasonography-guided drainage of the abscess was performed, and the sample tested positive for Cartridge-based Nucleic Acid Amplification Test, confirming TB. The patient was started on antituberculosis treatment, leading to complete resolution of the swelling with no recurrence during a 2-year follow-up. This case emphasises the importance of maintaining a high index of suspicion for TB in cases of dacryoadenitis unresponsive to antibiotics, especially in endemic regions like India.<\/jats:p>","DOI":"10.1136\/bcr-2024-264740","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T02:36:15Z","timestamp":1743734175000},"page":"e264740","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Tubercular osteomyelitis masquerading as acute dacryoadenitis"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0532-4294","authenticated-orcid":false,"given":"Aarushi","family":"Saini","sequence":"first","affiliation":[{"name":"Ophthalmology, Guru Nanak Eye Centre, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jolly","family":"Rohatgi","sequence":"additional","affiliation":[{"name":"Ophthalmology, University College of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajender","family":"Prasad","sequence":"additional","affiliation":[{"name":"Ophthalmology, University College of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7858-956X","authenticated-orcid":false,"given":"Anupama","family":"Tandon","sequence":"additional","affiliation":[{"name":"Radio-diagnosis, University College of Medical Sciences, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"key":"2025082710522562000_18.4.e264740.1","doi-asserted-by":"publisher","DOI":"10.1080\/01676830802225152"},{"key":"2025082710522562000_18.4.e264740.2","doi-asserted-by":"publisher","DOI":"10.4103\/0971-3026.59744"},{"key":"2025082710522562000_18.4.e264740.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(85)33818-6"},{"key":"2025082710522562000_18.4.e264740.4","first-page":"12","article-title":"Orbital involvement in tuberculosis","volume":"25","author":"Agrawal","year":"1977","journal-title":"Indian J Ophthalmol"},{"key":"2025082710522562000_18.4.e264740.5","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1097\/00041327-200209000-00004","article-title":"Orbital tuberculosis with abscess","volume":"22","author":"Aggarwal","year":"2002","journal-title":"J Neuroophthalmol"},{"key":"2025082710522562000_18.4.e264740.6","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3126\/nepjoph.v9i1.17542","article-title":"Tuberculous Osteomyelitis of Orbit- A Case Report","volume":"9","author":"Chakraborti","year":"2017","journal-title":"Nepal J Ophthalmol"},{"key":"2025082710522562000_18.4.e264740.7","doi-asserted-by":"crossref","first-page":"146","DOI":"10.18502\/jovr.v17i1.10181","article-title":"Tubercular Osteomyelitis of the Orbit Presenting as Periorbital Cellulitis","volume":"17","author":"Bhattacharya","year":"2022","journal-title":"J Ophthalmic Vis Res"},{"key":"2025082710522562000_18.4.e264740.8","doi-asserted-by":"crossref","first-page":"2","DOI":"10.4103\/2229-5178.93479","article-title":"Mantoux test and its interpretation","volume":"3","author":"Nayak","year":"2012","journal-title":"Indian Dermatol Online J"},{"key":"2025082710522562000_18.4.e264740.9","doi-asserted-by":"crossref","first-page":"S86","DOI":"10.1016\/j.ijtb.2020.09.025","article-title":"Tuberculosis: Newer diagnostic tests: Applications and limitations","volume":"67","author":"Chopra","year":"2020","journal-title":"Indian J Tuberc"},{"key":"2025082710522562000_18.4.e264740.10","unstructured":"Policy statement: automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: xpert MTB\/RIF system. Geneva: World Health Organization, 2011."},{"key":"2025082710522562000_18.4.e264740.11","doi-asserted-by":"publisher","DOI":"10.4103\/IJMR.IJMR_382_23"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-264740","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:52:33Z","timestamp":1756317153000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-264740"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4]]},"references-count":11,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,3]]},"published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1136\/bcr-2024-264740"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-264740","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,4]]}}}