Beyond the Lungs: Presumptive Tuberculous Dacryoadenitis Associated with Latent Tuberculosis Infection

Abstract

We report a case of a 30-year-old woman working in a tuberculosis laboratory who presented with a two-week history of right periorbital swelling, pain, and redness. Examination revealed right eye dacryoadenitis with scleritis. Given her occupational exposure, strongly positive tuberculin skin test (TST) and positive Interferon-gamma Release Assay (IGRA) results, a presumptive diagnosis of orbital tuberculosis was made, despite the absence of microbiological or histopathological confirmation. The patient received anti-tuberculosis therapy, resulting in complete resolution of symptoms. This case highlights that dacryoadenitis with scleritis, though uncommon, should be considered in the differential diagnosis of atypical orbital presentations, particularly in endemic settings.