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PubMed1986

Dacryocystitis following Kawasaki's disease.

A 6 1/2-year-old white male child had developed bilateral dacryocystitis 1 year earlier, approximately 6 months after resolution of the acute phase of Kawasaki's disease. The patient had had no previous history of dacryostenosis or epiphora. After he failed to respond to appropriate antibiotic therapy, probing was partially successful on the right side, but complete obstruction persisted on the left side. At age 7 1/2 years, dacryocystorhinostomy was performed successfully on the left side. To our knowledge, dacryocystitis has not been reported previously following Kawasaki's disease. Other reported ocular complications of Kawasaki's disease, with the exception of a case of bilateral conjunctival scarring, have occurred in the acute phase of the disease.

Child↗
PubMed1993

Clinical bacteriology of dacryocystitis in adults.

To better define the spectrum and relative incidence of pathogens causing dacryocystitis in adults, samples of purulent lacrimal sac contents were obtained from 236 patients undergoing dacryocystorhinostomy for a clinical diagnosis of dacryocystitis. Positive culture results were obtained in 52.5%. Cultures were pure, consisting of a single organism in 71%, and were mixed in 29%. Gram-positive organisms were most common, accounting for 64.5% of the isolates. Staphylococcus epidermidis, comprising 27.3% of the isolates and Staphylococcus aureus, comprising 22.1% of the isolates, were the most frequently encountered organisms. Gram-negative organisms were present in 27.3% of the isolates with Pseudomonas aeruginosa the most common, accounting for 8.7% overall. Anaerobic organisms were found in 7.0% of the isolates with Propionibacterium acnes the most frequent, recovered in 4.7% overall. Unexpected findings included the paucity of Streptococcus pneumoniae organisms recovered and the high incidence of involvement by gram-negative and anaerobic organisms.

Acute Disease↗
PubMed2001

Chronic dacryocystitis in American mucocutaneous leishmaniasis.

PURPOSE: This study describes lacrimal tract involvement and surgical outcome in patients with mucocutaneous leishmaniasis. METHODS: Four patients, ages 20 to 75 years, had nasal lesions resulting from mucocutaneous leishmaniasis and sought treatment for chronic dacryocystitis. Each patient had had lacrimal symptoms since childhood or early adulthood, concomitantly with the development of upper airway lesions. Dacryocystography showed nasolacrimal duct stenosis in all cases on the affected side. Three patients underwent dacryocystorhinostomy (one bilaterally), and one patient had bilateral dacryocystectomy. RESULTS: Two patients had surgical fistula closure soon after surgery. A sequential endoscopic operation for remotion of a synechia between the fistula and the middle turbinate was successful in one of these patients. Histopathologic analysis of lacrimal sacs and nasal mucous membranes close to the anastomotic site revealed chronic nonspecific inflammatory process and negative immunohistochemistry for Leishmania. CONCLUSIONS: Dacryocystitis may result from nasal mucocutaneous leishmaniasis. The surgical outcome was unsatisfactory in one of the four patients.

Adult↗
PubMed1997

Silicone punctal plug migration resulting in dacryocystitis and canaliculitis.

PURPOSE: One of the modalities of treating dry eyes is punctal plugs. They are usually used for temporary occlusion of the lacrimal drainage system. Among the complications associated with silicone punctal plugs are extrusion, downward migration, irritation, and epiphora. To our knowledge, this is the first report of dacryocystitis and canaliculitis as a result of spontaneous migration of punctal plugs into the lacrimal drainage system. METHODS: We describe the sequelae of spontaneous migration of silicone punctal plugs into the lacrimal drainage system in two patients with dry eyes. RESULTS: In two patients, spontaneous migration of silicone punctal plugs into the canaliculus or the lacrimal sac, respectively, resulted in canaliculitis or dacryocystitis. CONCLUSION: Smaller sized newer generation punctal plugs were designed to facilitate insertion; however, this design also increases the likelihood of proximal migration within the lacrimal drainage system. The importance of monitoring patients after punctal-plug placement cannot be over-emphasized.

Adult↗
PubMed1999

Co-occurrence of pneumococcal keratitis and dacryocystitis.

PURPOSE: To evaluate the specific risk factors responsible for the development of pneumococcal keratitis. METHODS: In a retrospective analysis of 383 patients of culture-proven bacterial keratitis, seen between 1991 and 1995, 139 had monobacterial isolates on culture. We analyzed the various predisposing factors in these patients, with special emphasis on the patency of nasolacrimal drainage system. RESULTS: Of the 139 patients with monobacterial keratitis, 48 (group 1) grew Streptococcus pneumoniae in culture. In the remaining 91 patients (group 2), Pseudomonas (18), coagulase-negative Staphylococci (15), Staphylococcus epidermidis (23), Staphylococcus aureus (16), Corynebacterium species (12), and others (seven) were isolated. Trauma was found to be a predisposing factor in 12 patients of group 1 and 27 patients of group 2 (p = 0.5601). Twelve (25%) patients of group 1 revealed chronic dacryocystitis, and nine of them underwent sac excision. On the contrary, only three patients of group 2 demonstrated dacryocystitis (p = 0.0003). CONCLUSION: These results underscore the importance of assessing the patency of lacrimal drainage system in patients with infectious keratitis, especially of pneumococcal origin.

Adolescent↗
PubMed1992

Acquired dacryocystitis: microbiology and conservative therapy.

The dacryocystitis in adults is mainly caused by postsaccal stenosis of the lacrimal ducts. The banking up of the lacrimal fluid leads to an accumulation of germs and following infection. This report describes the clinical and microbiological findings in a large consecutive series of patients that presented at the outpatient clinic of the 2nd Department of Ophthalmology of the University of Vienna with the signs of acute, chronic recurrent or chronic infections of the lacrimal system between 1983 and the end of 1990. Within the bacterial genus Staphylococci (S. aureus, S. epidermidis and S. saprophyticus) were the most frequently isolated organisms (74 cultures = 50% out of samples with positive cultures). It was quite interesting that a significant number of gram-negative rods (37 = 25.5%) could be isolated. Of these microorganisms Escherichia coli was most frequently growing on special media (17 cases = 11.7%) when cultures were obtained from acute inflamed lacrimal sacs of patients who suffered from chronic recurrent infections. Conservative therapy of purulent dacryocystitis constitutes the last possible preparation for a necessary surgical intervention and therefore the authors want to point out the importance of microbiological examinations so as to optimize antibiotic therapy.

Acute Disease↗
PubMed1993

The effect of dacryocystorhinostomy on tear film flow and stability in patients with chronic dacryocystitis.

In 30 patients suffering from chronic dacryocystitis, tear film flow and stability were assessed by means of Schirmer I and break-up time tests before and after dacryocystorhinostomy. When compared with those of healthy individuals, mean values of Schirmer I tests were found to be decreased before dacryocystorhinostomy, but reached normal levels after a successful operation. Break-up time levels were found to be within normal limits before and after surgery and no statistically significant difference was observed between patients and control group. These findings not only confirm the previous findings, that tear secretion in patients with chronic dacryocystitis was reduced and break-up time was not affected, but also indicate that the reduction of tear secretion can be eliminated by a successful dacryocystorhinostomy.

Adult↗
PubMed1977

Actinomycotic dacryocystitis.

The case history and the diagnostic considerations of dacryocystitis caused by Actinomyces israelii in a 40-year-old female patient are presented. It is very rare that Actinomyces is the cause of a darcryocystitis and only few descriptions of this entity are known from the literature. The course of this dacryocystitis is characterized by periods in which the patient is free of complaints, interspersed with acute fistulizing exacerbations.

Actinomycosis↗
PubMed2004

Endoscopic dacryocystorhinostomy in cases of dacryocystitis due to atrophic rhinitis.

Atrophic rhinitis is a chronic inflammatory disease of the nose, which is more common in India. Chronic dacryocystitis is its rare complication. The authors found four cases of chronic dacryocystitis from March 2002 to October 2003 due to atrophic rhinitis. It was diagnosed clinically by the regurgitation test and lacrimal syringing. These cases were treated conservatively for a period of six weeks to make the nasal mucosa healthier and were then subjected to endoscopic dacryocystorhinostomy (end-DCR) under local anaesthesia. The procedure was found to be more difficult due to bleeding and the healing time was prolonged as compared to other cases of end-DCR. After one to one and half years of follow-up the primary success rate was 75 per cent but after revision surgery in one case, all cases were successful. Hence it was concluded that atrophic rhinitis is no more a contraindication for end-DCR. However, meticulous initial preparation and post-operative follow-up is necessary to improve the result.

Adolescent↗
PubMed2006

A silastic sheet found during endoscopic transnasal dacryocystorhinostomy for acute dacryocystitis.

PURPOSE: To report the case of a silastic sheet that was found during an endoscopic transnasal dacryocystorhinostomy for treatment of acute dacryocystitis with necrosis of the lacrimal sac. METHODS: A thirty-two year old male presented with painful swelling on the nasal side of his left lower lid two weeks prior to visiting this clinic. Fourteen years ago, the patient was involved in a traffic accident and underwent surgery to reconstruct the ethmoidal sinus. Lacrimal sac massage showed a regurgitation of a purulent discharge from the left lower punctum. Therefore, the patient was diagnosed with acute dacryocystitis and an endoscopic transnasal dacryocystostomy was performed the next day. RESULTS: The surgical finding showed severe necrosis around the lacrimal sac and a 20 x 15-mm sized silastic sheet was found crumpled within the purulent discharge. The sheet was removed, the lacrimal sac was irrigated with an antibiotic solution, and a silicone tube was intubated into the lacrimal pathway. After surgery, the painful swelling on the nasal side of left lower lid resolved gradually, and there were no symptomatic complications three months later. CONCLUSIONS: We report the first case where a silastic sheet applied during a facial reconstruction had migrated adjacent to the lacrimal sac resulting in severe inflammation.

Adult↗
PubMed1992

Bilateral dacryocystitis after punctal occlusion with thermal cautery.

A 61-year-old woman developed acute bilateral dacryocystitis secondary to Staphylococcus aureus 3 weeks after undergoing punctal occlusion with thermal cautery for keratoconjunctivitis sicca. The dacryocystitis resolved with intravenous antibiotics, aspiration of the lacrimal sacs, injection of sulfacetamide into the lacrimal sacs, and bilateral dacryocystorhinostomy. Preexisting bilateral nasolacrimal duct obstruction was postulated as the underlying cause. In these cases, irrigation of the lacrimal system is recommended before proceeding with punctal occlusion.

Anti-Bacterial Agents↗
PubMed2002

[Probing of lacrimal passage on congenital dacryocystitis].

PURPOSE: To investigate the effects of probing of lacrimal passage on congenital dacryocystitis. METHODS: 474 consecutive infants with congenital dacryocystitis were treated with probing of lacrimal passage. The data were retrospectively analyzed. RESULTS: In 474 eyes, there were 360 and 122 eyes with or without membranous block respectively, and 356 (98.89%) and 107 eyes (85.25%) with or without membranous resistance were respectively cured with probing of lacrimal passage; there were 12 eyes with stenosis and 8 eyes (66.67%) were cured. In operation, 1 and 3 eyes were respectively suffered from subcutaneous edema and laceration of canaliculus, but there was no baby suffered from infection or asphyxia. CONCLUSIONS: The effects of probing of lacrimal passage were related to the causes of obstruction of lacrimal passage, and it is very important to scrupulously feel in probing lacrimal passage.

Child, Preschool↗
PubMed2005

Microbiology of dacryocystitis among adults population in southern Australia.

Retrospective study on microbiology of dacryocystitis cases in adults was carried out at the Royal Victorian Eye and Ear Hospital (RVEEH). Sixty-four consecutive cases seen between March 2000 and June 2003 were included. Seventy-nine organisms were isolated from the sixty-six samples (1.2/specimen). Aerobic or facultative bacteria were recovered in 76 (96.2), fungi from two specimens (2.5%). And anaerobic bacteria from only one specimen (1.3%). Staphylococcus aureus (27), was most common followed by Pseudomonas aeruginosa (6), Proteus mirabilis (4), Hemophilus parainfluenza (4) and H. influenza (4). Fifty-four samples showed single organism while 12 samples showed multiple organisms. Overall, Gram-positive organisms were predominating (54.4%) over Gram negative (41.8%) organisms. The current bacteriology of lacrimal duct obstruction in the population served by the RVEEH should be taken into account while selecting first line antimicrobial treatment for dacryocystitis and in prophylaxis in lacrimal drainage surgery.

Adult↗
PubMed1991

Acute dacryocystic retention cured by inferior turbinate infracturing.

A 30-year-old man with recurrent acute dacryocystic retention had successful infracturing of the inferior turbinate bone in association with probing of the lacrimal outflow system. Enlargement of the inferior nasal meatus by fracturing the turbinate is easy to do and would be indicated before recommending a dacryocystorhinostomy in cases of acute dacryocystic retention in which the causative cast is difficult to eliminate even by large probes that can be passed down the nasolacrimal duct.

Acute Disease↗
PubMed1989

Dacryocystectomy for the treatment of dacryocystitis patients with Wegener's granulomatosis.

We evaluated a woman with Wegener's granulomatosis who was experiencing recurrent dacryocystitis. Nasolacrimal duct obstruction had been present for many years and epiphora was not a significant concern. Our experience with the development of nasalcutaneous fistulas following dacryocystorhinostomy in several patients with Wegner's granulomatosis led us to perform a dacryocystectomy. The functional result was good, and there were no problems with wound healing. Dacryocystectomy should be considered as an alternative to dacryocystorhinostomy for dacryocystitis in patients with Wegener's granulomatosis and similar disorders in whom epiphora is not a major complaint.

Adult↗
PubMed1985

Orbital cellulitis secondary to dacryocystitis following blepharoplasty.

The authors report what they believe to be the first case of a blepharoplasty procedure complicated by an acute postoperative dacryocystitis that precipitated orbital cellulitis. The patient had a preoperatively compromised nasolacrimal drainage system. Because acute dacryocystitis and resulting orbital cellulitis are potential postoperative complications of a blepharoplasty, blepharoplasty candidates should undergo preoperative evaluation of their nasolacrimal drainage systems.

Cellulitis↗
PubMedDate not supplied

[Timed retrograde catheterization of the nasolacrimal duct as a method of treatment in congenital dacryocystitis and acquired stenosis of the nasolacrimal duct in children].

The authors propose a procedure of timed catheterization of the nasolacrimal duct for use in children with the duct stenosis and congenital dacryocystitis. The catheter is inserted for 7-10 days. Out of 27 children treated (20 cases of congenital dacryocystitis and 7 cases of the stenosis), a persistent effect was achieved in 24. The authors advocate the method as effective and promising in the above conditions.

Adolescent↗