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[Craniofacial dysraphism and dacryocystitis].

Two clinical observations with craniofacial dysraphism and affecting of the lacrimal ways are presented. The first observation was done on a 34-years-old patient, with medical craniofacial perforation (3-12), with telorbitism, right operated meningocele and left suprainfected lacrimal mucocele. The accentuated craniofacial dysraphism didn't permit dacryocystorhinostomy and imposed the extirpation of the left lacrimal mucocele. The second observation was done on a 6-years-old child with paramedian craniofacial perforation (3-11) and left suppurated dacryocystitis. The extirpation of the lacrimal bag was followed by purulent meningitis through continuity solution existent at the craniofacial level. It was insisted on effecting a through examination in craniofacial perforations for finding a craniocerebral continuity solution in the interventions done on lacrimal ways.

Adult↗

PubMed1993

[Recurrent canaliculitis and dacryocystitis as a sequela of persistent infection with Chlamydia trachomatis].

We report on 4 patients aged 39-62 years with follicular conjunctivitis, canaliculitis, canalicular obstruction, dacryocystitis and nasolacrimal duct obstruction caused by chronic oculogenital infection with Chlamydia trachomatis. Microbiological diagnosis was accomplished by means of the McCoy cell culture technique as a highly specific tool for detection of the chlamydial infection. In addition, serological tests (IgA-IPA and IgG-IPA techniques) were performed. Bacteriological examination of conjunctival smears showed coinfection in 3 patients (Proteus mirabilis in 1, Staphylococcus aureus coagulase-positive in 3). Despite successful operation techniques, the obstructive inflammation caused by oculogenital chlamydial infection could only be cured by systemic treatment with specific antibiotics, such as doxycycline or erythromycin. All cases of chronic follicular conjunctivitis with lacrimal inflammation that are resistant to topical antibiotics should suggest the possibility of infection with Chlamydia trachomatis.

Adult↗

PubMed1996

Acute dacryocystitis: an unusual cause of life-threatening orbital intraconal abscess with frozen globe.

An 84-year-old woman developed a markedly proptotic right eye with external ophthalmoplegia and displacement of the globe into the superotemporal orbit. She had minimal pain and no history of the usual predisposing causes of orbital cellulitis. Vision was unaffected. Orbital computed tomography (CT) showed an extraconal inferomedial abscess with an adjacent intraconal component. A purulent abscess in the anterior inferomedial aspect of the orbit, which extended into the medial aspect of the intraconal space, was incised and drained. After surgery, the orbital inflammation and proptosis resolved, but an irreducible, nonpurulent lacrimal sac mucocele persisted. A dacryocystectomy was performed. Pathologic examination of the lacrimal sac biopsy specimen showed only chronic nongranulomatous inflammation. This case demonstrates that acute dacryocystitis may cause an intraconal orbital abscess with proptosis and complete external ophthalmoplegia, and represent a sight- and life-threatening condition.

Abscess↗

PubMed1976

Acute dacryocystic retention.

Acute dacryocystic retention is a disease of adults under 50 years old due to a noninfective foreign body blocking the nasolacrimal duct. It is characterized by the sudden onset of severe unilateral facial pain without significant localized swelling or erythema. Palpation of the involved lacrimal sac reveals slight induration and marked tenderness. Percutaneous aspiration of lacrimal sac contents, followed by probing of the nasolacrimal duct, is usually curative.

Acute Disease↗

PubMed2002

Choanal stenosis, hypothelia, deafness, recurrent dacryocystitis, neck fistulas, short stature, and microcephaly: report of a case.

We report on a 11-year-old girl with bilateral choanal stenosis, hypothelia, hearing loss, recurrent dacryocystitis, neck fistulas, short stature, and microcephaly. Only three individuals with choanal atresia from a consanguineous family have been reported. One of the patients also had hypoplastic nipples, hypotonia, and delay in speech development. Similar clinical features were seen in two children reported by Greenberg [1987: Am J Med Genet 28:931-934] and Wilson et al. [1998: Am J Med Genet 75:220-222]. They were prenatally exposed to methimazole because of maternal Graves disease. Neck fistulas and microcephaly noted in our patient were not previously reported as features of the syndrome or in the patients prenataly exposed to methimazole. Our patient and those reported by Qazi et al. [1982: Am J Med Genet 13:413-416] most probably have a rare syndrome characterized by this distinctive combination of symptoms. Prenatal exposure to methimazole can cause a phenocopy of the syndrome, which was probably the case in the patients reported by Greenberg and Wilson et al.

Abnormalities, Multiple↗

PubMed1989

Recognition and management of acute noninfectious dacryocystic retention.

Eleven female and 4 male patients presented with 20 documented episodes of acute noninfectious dacryocystic retention. This syndrome complex consists of severe pain and tearing with minimal but tender distention of the lacrimal sac, without signs of inflammation. It is caused by impaction of a dacryolith in the nasolacrimal duct. In our group of patients, the mean age when seen was 39 +/- 14 years, and the mean onset of symptoms occurred at age 35 +/- 13 years. Six episodes resolved spontaneously, and the rest responded to interventional therapy. In six, irrigation relieved the symptoms. One patient each responded to probing, lacrimal intubation, and primary dacryocystorhinostomy (DCR). In three patients, a new technique of percutaneous nasolacrimal duct dilatation using angiographic techniques relieved symptoms. One patient each failed irrigation and percutaneous dilatation and required secondary DCR. Recognition of this presentation permits differentiation of this syndrome from infectious lacrimal obstruction and allows appropriate therapy. In at least some patients, percutaneous nasolacrimal duct dilatation may offer both a method of accurate diagnosis and an initial alternative to more extensive surgery.

Acute Disease↗

PubMed2000

Curvularia dacryocystitis: report of two cases.

Two cases of ocular mycosis caused by the genus Curvularia are reported. In these cases, the infection was localised to the lacrimal sac only and presented in the form of acute to chronic dacryocystitis. Interestingly, neither of the hosts was immunocompromised. The authors have not been able to find a similar presentation of ocular mycosis caused by Curvularia localised to the lacrimal sac in the literature. The relevant literature pertaining to ocular involvement with this fungus is discussed. The authors recommend the use of oral fluconazole for a minimum of two weeks for the treatment of such infections as a good therapeutic response was obtained with this agent in both their cases.

Journal Article↗

PubMed1954