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An otherwise healthy man in his early 20s presented with a chronic, intermittently discharging, nonhealing sinus over the left upper eyelid of about 3 months’ duration (Figure). There were no other associated visual or systemic concerns. History of a left upper eyelid abscess, incised and drained elsewhere, was elicited. Previous medical records were not available. Computed tomography imaging was suggestive of chronic osteomyelitis. Systemic investigation revealed multiple lung parenchymal infiltrates on chest radiography and isolation of acid-fast bacilli from the sputum. A diagnosis of pulmonary tuberculosis was thus established.1-3 Standard antitubercular treatment with first-line drugs was instituted and the sinus discharge resolved completely while receiving treatment.
A young man with a chronic, nonhealing, discharging sinus in the left upper eyelid sulcus (arrowhead [A]) showed abnormalities of chronic osteomyelitis (a scalloped bony cavity with sequestrum, arrowhead [B]) in the greater wing of the sphenoid on computed tomography.
Corresponding Author: Devjyoti Tripathy, MS, Ophthalmic Plastics, Orbit and Ocular Oncology Services, LV Prasad Eye Institute, Patia, Bhubaneswar 751024, Odisha, India (email@example.com).
Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Singh S, Tripathy D. Burrow in the Sphenoid: A Clue to Occult Pulmonary Tuberculosis. JAMA Ophthalmol. 2015;133(10):e151498. doi:10.1001/jamaophthalmol.2015.1498
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