title: Primary nasolacrymal tuberculosis diagnosed after dacryocytorhinostomy.
abstract: Although tuberculosis (TB) is common and well recognized in many countries, unusual presentations of the disease sometimes raise difficulties in differential diagnosis. Primary tuberculosis of the lacrimal sac and the nasolacrimal duct is an extremely rare presentation of extra-pulmonary tuberculosis. Dacryocystorhinostomy alone is not sufficient for the treatment of these patients and an anti-tuberculous therapy has to be added. Here we present a patient with primary tuberculosis, which is limited to the inferior meatus and filled the entire lacrimal sac on the left side. The patient underwent endoscopic dacryocystorhinostomy due to obstruction of the nasolacrimal duct and culture of the granulation tissue, taken from the lacrimal sac revealed mycobacterial tuberculosis. The patient was improved with anti-tuberculous therapy that was added to the surgery. Primary tuberculosis is a rare granulomatous disease of the nasolacrimal system, which should be considered in the differential diagnosis to plan the effective treatment.
authors.affiliation: Department of ORL & HNS, Gülhane Military Medical School, Etlik 06018, Ankara, Turkey. fuattosun@yahoo.com
authors.forename: Fuat
authors.initials: F
authors.lastname: Tosun
authors.forename: Ergun
authors.initials: E
authors.lastname: Tozkoparan
authors.forename: Cuneyt
authors.initials: C
authors.lastname: Erdurman
authors.forename: Fatih
authors.initials: F
authors.lastname: Ors
authors.forename: Omer
authors.initials: O
authors.lastname: Deniz
mesh_terms: D000995:Antitubercular Agents / Q000627:therapeutic use; D003608:Dacryocystorhinostomy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000175:diagnosis*; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery; D011182:Postoperative Care; D014057:Tomography, X-Ray Computed; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000601:surgery
chemical_list: D000995:Antitubercular Agents