유루로 내원한 원발성 눈물주머니 결핵 1예
A Case of Primary Tuberculosis of the Lacrimal Sac Presenting as Epiphora
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Extra-pulmonary tuberculosis usually progresses as a secondary infection from pulmonary tuberculosis,and tuberculosis of the head and neck region. Tuberculosis of ocular and periocularareas, however, is a rare disease. Among ocular tuberculosis involving the adnexal structures, afew lacrimal sac tuberculosis has been reported. We recently experienced a case of lacrimal sactuberculosis presenting as epiphora. Examination revealed bilateral nasolacrimal duct obstructionand the patient underwent endoscopic endonasal dacryocystorhinostomy. During the operation,a biopsy taken from the unhealthy looking lacrimal sac filled with caseous necrotic tissuewas suggestive of tuberculosis. Histopathological features and further systemic evaluation confirmedtuberculosis. She was treated medically with anti-tubercular agents. The new openingof the lacrimal sac was patent and epiphora was resolved successfully at a year follow up. Thisreport highlights the requirement of high suspicion of tuberculosis, even in the nasolacrimaldrainage system.
Abstract
Extra-pulmonary tuberculosis usually progresses as a secondary infection from pulmonary tuberculosis,and tuberculosis of the head and neck region. Tuberculosis of ocular and periocularareas, however, is a rare disease. Among ocular tuberculosis involving the adnexal structures, afew lacrimal sac tuberculosis has been reported. We recently experienced a case of lacrimal sactuberculosis presenting as epiphora. Examination revealed bilateral nasolacrimal duct obstructionand the patient underwent endoscopic endonasal dacryocystorhinostomy. During the operation,a biopsy taken from the unhealthy looking lacrimal sac filled with caseous necrotic tissuewas suggestive of tuberculosis. Histopathological features and further systemic evaluation confirmedtuberculosis. She was treated medically with anti-tubercular agents. The new openingof the lacrimal sac was patent and epiphora was resolved successfully at a year follow up. Thisreport highlights the requirement of high suspicion of tuberculosis, even in the nasolacrimaldrainage system.
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