ophthalmology Posted By Mohan Rajan Date : 08-Sep-00
I am sending you the case summary of one of our patients Mrs.S aged >36 years(Mr N0.47249).She was seen by us on 29/8/00 with complaints of painful swelling in the right upper eyelid for the past 10 days.
On examanation she had puffiness of the lids with conjuctival congestion and chemosis of the right eye .On palpation ,there was indurated mass over the right lacrimal gland region with tender preauricular & cervical lymphadenopathy. VA was 6/9 , N6 in OD and 6/6, N6 in OS.
We suspected ? Dacryoadenitis.
Patient was admitted and was given injection clafaron (Cefatoxime) and Decadran. In addition oral H2 blocker and multi Vitamin started.
PPBS = 188 mg % Platelets = 265000/cu.mm S. Creatinine = 0.8mg % Peripheral smear =normal RA factor = 19 IU/ml Mantoux positive (10mm) CRP = 4 mg / dl WBC = 10600 P65 L34 E1 ESR = 15mm at1 hr Hb = 11.8 g% RBC = 4.2 million/cu.mm MCV = 85 MCH =28.2 MCHC =33.2 %
CT scan brain - Normal CT Scan orbit -> Soft tissue mass with well defined margin measuring 23 x 9 mm in right lacrimal gland indenting right eye ball. No evidence of bony erosion or proptosis.
She was seen today above reports. Puffiness has reduced but indurated mass persists. We seek your opinion and advice regarding further medical/ surgiccal management of this patient. Give us your opinion.
Dr. Mohan Rajan