Primary tubercular osteomyelitis of lateral orbital wall: a rare presentation.

Osteomyelitis of facial bones is a very rare presentation. Primary presentation of tubercular osteomyelitis in facial bones is even rarer. We are reporting a case of zygomatic tubercular osteomyelitis presenting in a very innocuous way. Identification of such cases in early stage can help in timely intervention. A 30 years old female presented to Ophthalmology Out Patient Department (OPD) with complain of a mildly painful nodule over left lower eyelid, turning into an ulcer. After appropriate investigation, diagnosis of primary tubercular osteomyelitis of left zygomatic bone was made and patient underwent debridement and anti-tubercular treatment. Patient has healed satisfactorily, with no sinus formation, no residual bony on filtration and good cosmetic results. Early diagnosis and timely management of such cases can avoid extensive involvement of bone, thereby reducing the subsequent morbidity of the patients.