Multifocal cystic bone tuberculosis with lupus vulgaris and lymphadenitis.

via cavernous sinus and intracranial propagation of periorbital cellulitis. This was not required in our case due to probably institution of appropriate antibiotic therapy. It may be of merit in severe or late diagnosed cases. Staphylococcal colonization of nasopharynx can lead to ethmoiditis in immunocompromized or susceptible child, with rapid progress locally and hematogenous seeding as in our case. A variety of organisms other than staphylococcus can cause this infection, which is dangerous because it may be complicated by retrobulbar abscess and cavernous sinus infection and thrombosis. Treatment should be started early with intravenous antibiotics. Also, concomitant staphylococcal foci should be looked for and dealt with surgically if necessary. If in any doubt, a contrast enhanced