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At least 19 recordsLinked to original sources
PubMedDate not supplied

Spectrum of pediatric dacryocystitis: medical and surgical management of 54 cases.

BACKGROUND: Dacryocystitis in infants and older children is a serious complication of congenital or acquired nasolacrimal duct obstruction. To define the modes of presentation and treatment strategies of this disorder better, we reviewed the clinical courses of 54 children treated for dacryocystitis at St Louis Children's Hospital. METHODS: Clinical, neuroradiologic, and laboratory data were collated for all cases of dacryocystitis treated from 1990 to 1995. Average follow up of the children in this consecutive series was 1.75 years (range, 4 months to 5 years). RESULTS: Of the 54 patients, 36 (67%) had chronic low-grade dacryocystitis, which was treated with nasolacrimal duct probing on an outpatient basis. The remaining 18 patients (33%) had acute dacryocystitis, which was treated with a combined medical/surgical strategy. Medical treatment consisted of hospital admission for administration of intravenous antibiotics followed by inpatient surgery, which varied according to the age of the patient and the clinical history: 1) Acute dacryocystitis in neonates was treated surgically by nasolacrimal duct probing and nasal endoscopy for excision of intranasal duct cyst; 2) Acute dacryocystitis with periorbital cellulitis was treated surgically by nasolacrimal duct probing; 3) Acute dacryocystitis due to facial trauma was treated surgically by dacryocystorhinostomy and stent placement; and 4) Acute dacryocystitis complicated by orbital abscess was treated by inferior orbitotomy for orbital abscess drainage, simultaneous nasolacrimal duct probing, and stent placement. CONCLUSION: Dacryocystitis in the pediatric population may present in either chronic or acute forms. An effective and safe treatment for acute dacryocystitis is hospital admission, both for administering intravenous antibiotics and monitoring to rule out orbital cellulitis or abscess formation. Intravenous antibiotic therapy is followed within a day or two by surgery tailored to the clinical history. In the majority of both chronic and acute cases, nasolacrimal duct probing appears to be an effective treatment strategy.

Abscess↗
PubMed1997

Surgical treatment of dacryocystitis.

Dacryocystitis is a common infection of the lacrimal sac. In adults, dacryocystitis results from an obstruction (ie, dacryostenosis) of the nasolacrimal duct. Dacryocystitis can be either an acute or chronic infection, and both forms usually are unilateral in nature. The hallmark symptom of both forms of dacryocystitis is epiphora (ie, excessive tearing). An obstruction of the lacrimal duct also can cause dacryocystitis. This article discusses the surgical treatment of dacryocystitis and provides a case study that illustrates perioperative nursing care of a patient who required surgical treatment of this lacrimal duct disorder.

Adult↗
PubMedDate not supplied

Dacryocystorhinostomy for dacryocystitis caused by methicillin- resistant Staphylococcus aureus: report of four cases.

BACKGROUND: To evaluate the outcome of dacryocystorhinostomy (DCR) for dacryocystitis caused by methicillin-resistant Staphylococcus aureus (MRSA). CASES: Four otherwise healthy patients with dacryocystitis caused by MRSA were studied (3 with chronic dacryocystitis; 1, acute dacryocystitis). Ophthalmic symptoms were epiphora with purulent discharge in 2 cases, with blepharoconjunctivitis in 1 case, and with lacrimal fistula in 1 case. Culture of the purulent discharge from the affected conjunctival sacs revealed MRSA infection. Initial treatment, which was unsuccessful, included intravenously administered common antibiotics, the use of topical antibiotics and povidone-iodine in the conjunctival sac and mupirocin ointment in the nasal cavity. Subsequently, standard DCR was performed with a bicanalicular silicone tube inserted under local anesthesia, accompanied by the administration of common antibiotics. OBSERVATION: Cultures from all patients were negative for MRSA as soon as 4 days after DCR. None of the patients had epiphora with pus, and the lacrimal passage became patent postoperatively. CONCLUSION: Dacryocystitis due to MRSA was resistant to conservative therapy. DCR subsequent to the conservative therapy resulted in almost immediate resolution of the lacrimal fistula and nasolacrimal obstruction, rapid control of dacryocystitis, and a decrease in the period of MRSA infection in the conjunctiva and the nasal cavity.

Aged↗
PubMed1993

Acute dacryocystitis secondary to exudative rhinitis.

This report describes the unusual occurrence of acute dacryocystitis secondary to exudative rhinitis. An 18-year-old man with no prior history of tearing or dacryocystitis presented with acute left dacryocystitis. Nasal mucosal edema, lymphoid hyperplasia, and exudate obstructed the ostium of his left nasolacrimal duct. The patient improved rapidly with systemic antibiotic and nasal decongestant drugs. Both the nasolacrimal duct obstruction and dacryocystitis resolved completely within 2 weeks. One year later, serology suggested Epstein-Barr virus as the cause of the rhinitis. Acute intranasal inflammation may obstruct the nasolacrimal duct with potential secondary dacryocystitis. This type of nasolacrimal duct obstruction resolves without sequelae when the rhinitis improves.

Acute Disease↗
PubMed2001

Endonasal dacryocystorhinostomy in the primary treatment of acute dacryocystitis with abscess formation.

PURPOSE: To determine whether endonasal dacryocystorhinostomy may constitute effective primary treatment of acute dacryocystitis with lacrimal sac abscess formation. METHODS: This was a retrospective review of a series of 24 patients with acute dacryocystitis and lacrimal sac abscess who underwent endonasal dacryocystorhinostomy as a primary procedure. Outcome measures included resolution of signs and symptoms of acute dacryocystitis as well as intranasal ostium patency as assessed by lacrimal irrigation. RESULTS: Pain was relieved in all patients within 3 days of surgery, and swelling resolved in all patients by 9 days after surgery. Ostium patency, as defined by the absence of epiphora, and free lacrimal irrigation was achieved in 20 (83%) of 24 patients, with follow-up of 27 to 59 months (mean, 40 months). Recurrent epiphora developed in four patients; recurrent dacryocystitis developed in none. CONCLUSIONS: Endonasal dacryocystorhinostomy may be a useful option in the treatment of acute dacryocystitis with abscess formation.

Abscess↗
PubMedDate not supplied

Treatment of acute dacryocystitis in neonates.

Twenty-five newborns with acute dacryocystitis underwent probing of the nasolacrimal duct. All had a resolution of the acute dacryocystitis. Only one continued to have epiphora and had to undergo a subsequent probing with silicone intubation at 9 months of age. All were probed without anesthesia, being mummified and held by nurses while the author performed the probing. Only five were treated with parenteral and topical antibiotics for a week prior to probing while 20 were probed without any prior antibiotic therapy. Additionally, five of six mucoceles of the lacrimal sac which did not resolve in the 1st 2 weeks of life with massage were successfully probed without anesthesia. Four of the five mucoceles had developed an acute dacryocystitis on conservative management. Probing of the nasolacrimal duct in the newborn period is a safe and successful approach for acute dacryocystitis. It is a highly successful procedure for the treatment of acute dacryocystitis with a very low morbidity rate.

Acute Disease↗
PubMedDate not supplied

Fungal flora in congenital dacryocystitis.

In this study, 86 eyes in 66 cases (20 bilateral) of congenital dacryocystitis were analysed for fungal growth. Fungi alone were isolated in 12 eyes (13.95%) and in 14 eyes (16.28%) together with bacteria--a total of 26 positive for fungus in 86 eyes (30.23%). These 26 eyes yielded on fungal culture a total of 28 isolates (in 2 eyes, another fungus was isolated on repeat culture). 11 types of fungi were cultured--C. albicans and A. niger accounted for 5 each out of 28. To the best of our knowledge this is the first report in the literature of fungal flora analysed in congenital dacryocystitis--not surprisingly, more than 30% of eyes were positive for fungus. Systemic studies of fungal flora in dacryocystitis are very few, and hardly any literature on this subject exists in congenital dacryocystitis. This study is an attempt to determine the frequency and clinical significance of fungi isolated from cases of congenital dacryocystitis.

Dacryocystitis↗
PubMed1993

Dacryocystitis associated with malignant lymphoma of the lacrimal sac.

BACKGROUND: Tumors of the lacrimal sac are unusual, and lymphomas of the lacrimal sac are quite rare. Four patients with a history of well-differentiated, small cell lymphoma or chronic lymphocytic leukemia presented with either acute or chronic dacryocystitis and epiphora due to lymphomatous infiltration of the lacrimal sac. METHODS: All four patients underwent dacryocystorhinostomy with lacrimal sac biopsy. All tissues underwent complete histopathologic evaluation including immunohistochemical studies for cell surface markers and, in addition, were compared with previous biopsies performed for the initial diagnosis of lymphoma. FINDINGS: All biopsies demonstrated small cell well-differentiated lymphoma on histologic and immunofluorescent examination. No patient demonstrated orbital involvement on computed tomography. One patient had previously diagnosed chronic lymphocytic leukemia and one patient demonstrated diffuse lymph node involvement on postoperative systemic evaluation. All four patients underwent additional chemotherapy. No recurrence of dacryocystitis or epiphora occurred. CONCLUSION: Four patients presented with dacryocystitis secondary to lacrimal sac lymphoma. Lymphomatous lacrimal sac infiltration is an unusual cause of dacryocystitis. Biopsy of the lacrimal sac plays a diagnostically important role in dacryocystorhinostomy even in the absence of obvious tumorous involvement of the lacrimal sac mucosa.

Acute Disease↗
PubMed1993

Chronic dacryocystitis caused by Mycobacterium fortuitum.

PURPOSE: To characterize the clinical presentation of Mycobacterium fortuitum dacryocystitis, an unusual microbial cause of this disease. METHODS: The authors present a detailed description of a case of M. fortuitum chronic dacryocystitis and a review of the literature. FINDINGS: Although M. fortuitum is a well-recognized cause of chronic keratitis and corneal ulcer, it has only been reported once previously as a cause of dacryocystitis. Multiple factors that alter the ocular environment of the host may predispose to infection with this organism. The diagnosis requires isolation of the organism in the appropriate clinical setting. The authors' case represents the first patient successfully treated with dacryocystectomy. CONCLUSION: M. fortuitum is a rare cause of chronic dacryocystitis that may respond favorably to surgical therapy alone.

Chronic Disease↗
PubMedDate not supplied

Neonatal dacryocystitis associated with nasolacrimal duct cysts.

Neonatal dacryocystitis is a rare complication of congenital nasolacrimal duct (NLD) obstruction. Recent reports suggest that the association of neonatal dacryocystitis and NLD cysts may be more common than previously believed. The purpose of this study is to describe the nasal endoscopic findings and treatment of three patients with this disorder. In this prospective study, three consecutive patients who presented at 2 weeks of age or less with dacryocystitis were treated with NLD probing and rigid nasal endoscopy. All patients were found to have congenital NLD cysts at the time of NLD probing. The cysts were marsupialized under endoscopic visualization. The treatment was successful in all patients. Dacryocystitis in the early newborn period is commonly associated with NLD cysts. Nasal endoscopic marsupialization of the cysts is an effective adjunct to treatment of these patients.

Cysts↗
PubMed1995

[Tuberculous dacryocystitis].

BACKGROUND: Acute infection and inflammation of the nasolacrimal sac may complicate congenital obstruction of the nasolacrimal duct. Acute dacryocystitis is uncommon later and tuberculosis is exceptionally responsible for it. CASE REPORT: A 4 1/2 year-old boy was admitted because he suffered from acute left dacryocystitis with fever and cervical adenitis. Involvement of both lacrymal gland and lymph node persisted despite antibiotic and corticosteroid therapy. Needle biopsy of the lymph node showed presence of Mycobacterium tuberculosis and excision revealed caseating granulomas. The tuberculin skin test was positive while pulmonary tuberculosis was discovered in the patient's father. The patient was successfully given izoniazid, rifampin for 9 months and pyrazinamide for 2. Drainage of the sac area was necessary after 1 month of treatment followed by dacryocystorhinostomy. CONCLUSION: This rare case of tuberculous dacryocystitis permits to delineate the difficulties of ophthalmologic therapy.

Acute Disease↗
PubMedDate not supplied

Lectin cytochemistry of the lacrimal sac epithelium in experimental dacryocystitis.

PURPOSE: To study the glycoconjugates in the lacrimal sac epithelium of Japanese white rabbits with experimentally induced chronic dacryocystitis. METHODS: Chronic dacryocystitis was induced by a subcutaneous injection of albumin followed by an injection of Staphylococcus aureus into the lacrimal sac. The histological appearance of the lacrimal sac was studied using the alcian blue-periodic acid-Schiff sequence. In addition, the specific binding to the lacrimal sac epithelium of Ulex europaeus agglutinin 1, Ricinus communis agglutinin 1, peanut agglutinin, and soybean agglutinin was also studied. RESULTS: Staining with alcian blue-periodic acid-Schiff sequence showed hyperplasia of the goblet cells in the inflamed lacrimal sac epithelium. Lectin cytochemistry revealed specific binding of Ulex europaeus agglutinin 1, Ricinus communis agglutinin 1, peanut agglutinin, and soybean agglutinin to the lacrimal sac epithelium. CONCLUSIONS: These results indicated that the composition of glycoconjugates in the lacrimal sac epithelium is markedly changed in dacryocystitis. There seems to be a fundamental abnormality in glycoconjugate synthesis in the chronically inflamed lacrimal sac epithelium.

Animals↗
PubMed2002

[Mycotic dacryocystitis related to naso-lacrimal stent. Case report].

CASE REPORT: A nasolacrimal stent was placed in a diabetic woman with a ten-year history of epiphora. Three months later the non-functional stent was removed and taken for histological study. A presumed diagnosis of fungical dacryocystitis was then established. An external dacryocystorhinostomy was performed and the obtained cultures confirmed Candida albicans as the infective agent. DISCUSSION: Only 1.2% of all dacryocystitis are due to fungal agents. This possibility must be considered when evaluating a routine chronic dacryocystitis. Cultures should be obtained when removing a nasolacrimal stent in order to rule out different causes of nasolacrymal obstruction.

Candidiasis↗
PubMed1999

[Treatment for chronic dacryocystitis by probing through naso-lacrimal duct under endoscopy].

OBJECTIVE: To determine the possibility of curing chronic dacryocystitis by probing through naso-lacrimal duct under endoscopy. METHOD: 30 adult eyes with chronic dacryocystitis were divided into two groups: 20 treated under endoscopy as endoscopy group and 10 under rhinoscope as control. RESULT: In endoscopy group, treatment in all 20 eyes successed at the first time, but in control group only in 8 of the 10 eyes successed at the first time and the other 2 needed second surgery. CONCLUSION: Treatment for chronic dacryocystitis by probing through naso-lacrimal duct under endoscopy is better.

Chronic Disease↗
PubMedDate not supplied

[Results of endonasal intubation of the nasolacrimal duct in children with congenital dacryocystitis].

Results of endonasal catheterization of the naso-lacrimal canal of 74 children with congenital dacryocystitis (bilateral problem in 10 of them) are presented. Prior to this manipulation, the patients were exposed to contrast X-ray study of the lacrimal sac for diagnostic purposes. Retrograde catheterization as a method for treating congenital dacryocystitis was very good in 97.3% children of up to 2 years old, 50% children of up to 3 years old, and 33.3% children between 3-4 years old. The patency of the naso-lacrimal canal also recovered in an 8-year-old child. All this gives evidence that, irrespective of children's age, retrograde catheterization should be applied to treat congenital dacryocystitis. After the patency of the naso-lacrimal canal was restored, the external fistula of the lacrimal sac was cauterized with 7% solution of trichloroacetic acid.

Adolescent↗
PubMed1989

[Problems of the diagnosis and differential treatment procedures in congenital dacryocystitis].

The paper analyses effectiveness of treatment for dacryocystitis in 223 children, aged from 1 months up to 15 years. In 35 children the process was bilateral. In 232 cases dacryocystitis was congenital, in 26--acquired. Complex examination of lacrimal and upper respiratory tracts has revealed pathology in 53% of cases. In these cases preliminary sanation of upper respiratory tracts was made. A scheme of a staged treatment for congenital dacryocystitis is proposed, and results after treatment by retrograde catheterization in 161 children aged to 1.5 year and by endonasal dacryorhinostomy in 62 children above 2.5 years of life are analysed.

Adolescent↗
PubMed1987

Dacryocystitis. Late complication of orbital floor fracture repair with implant.

Fifteen years after orbital floor fracture repair with a silicone implant, dacryocystitis unresponsive to medical management developed in a 66-year-old woman. On examination, the edge of the implant was palpable at the most medial aspect of the inferior orbital rim in the anatomic area of the nasolacrimal sac. Orbital computed tomography (CT) scan and intraoperative probing and irrigation of the nasolacrimal system confirmed that the implant obstructed the nasolacrimal sac at the floor of the orbit. Removal of the implant combined with dacryocystorhinostomy has led to resolution of the dacryocystitis. To the authors' knowledge, dacryocystitis as a late complication of orbital floor fracture repair with an orbital floor implant has not been previously reported. This case demonstrates that orbital floor implants should not be placed too anteriorly or too medially in the anatomic region of the lacrimal sac and that they should be fixed to prevent implant migration.

Aged↗
PubMed1996

Role of dacryocystectomy in the management of failed dacryocystorhinostomy associated with chronic dacryocystitis.

Three patients had recurrent chronic dacryocystitis but no epiphora associated with failed dacryocystorhinostomies. Dacryocystectomy was performed on all three patients. These patients were cured of dacryocystitis following dacryocystectomy and none had epiphora postoperatively. There may be a group of patients with dry eyes and chronic dacryocystitis in whom dacryocystorhinostomy is likely to fail. Such patients may respond favorably to dacryocystectomy.

Aged↗