title: Presumed localized tuberculous inflammation after periocular procedures.
abstract: OBJECTIVE
  To report 4 rare cases of periocular presumed tuberculosis that developed after eyelid and lacrimal drainage surgery.
  
  
  METHODS
  Retrospective, interventional case series. Review of clinical, laboratory, photographic, and radiologic records of patients with presumed tuberculous inflammation after periocular procedures.
  
  
  RESULTS
  Four patients had periocular presumed tuberculosis after blepharoplasty, dacryocystorhinostomy, and intracanalicular lacrimal plug insertion. Diagnosis was made by characteristic histopathologic findings, acid-fast bacilli staining, polymerase chain reaction results, or response to therapeutic trial. All of the patients underwent antituberculosis chemotherapy for a minimum of 9 months and all recovered. Ectropion and eyelid retraction complicated 2 cases.
  
  
  CONCLUSIONS
  Unresponsiveness of chronic inflammation to conventional treatment after periocular procedures should arouse the clinical suspicion of localized tuberculosis, particularly in endemic areas or in patients who have a tuberculosis history or recent exposure. For presumed eyelid tuberculosis without evidence of Mycobacterium tuberculosis, the clinical diagnosis and therapeutic trials could be considered cautiously especially in countries with an intermediate or high tuberculosis burden. Early diagnosis and appropriate treatment can prevent the sequelae of tuberculosis infection.
authors.affiliation: Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea.
authors.forename: Kyung In
authors.initials: KI
authors.lastname: Woo
authors.forename: Yoon-Duck
authors.initials: YD
authors.lastname: Kim
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D019882:Blepharoplasty / Q000009:adverse effects*; D004269:DNA, Bacterial / Q000032:analysis; D003608:Dacryocystorhinostomy / Q000009:adverse effects*; D003937:Diagnosis, Differential; D005143:Eyelids / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation; D007765:Lacrimal Apparatus / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D004269:DNA, Bacterial