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Key Features

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  • Caused by nasolacrimal obstruction

  • Acute and chronic dacryocystitis are typically caused by bacteria that colonize the upper respiratory tract, such as

    • Staphylococcus aureus

    • Streptococcus pneumoniae, Streptococcus pyogenes, Streptococcus viridans

    • Moraxella catarrhalis

    • Haemophilus species

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Clinical Findings

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  • Acute dacryocystitis

    • Presents with inflammation, swelling, tenderness, and pain over the lacrimal sac (located inferior to the medial canthal tendon)

    • Fever may be present

    • Purulent discharge and tearing

  • Chronic dacryocystitis

    • Mucopurulent debris on the lids and lashes

    • Tearing

    • Infection of the palpebral conjunctiva

    • Reflux of pus at the puncta when pressure is applied over the sac

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Diagnosis

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  • Clinical

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Treatment

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  • Severe acute dacryocystitis is treated with intravenous antibiotics after attempts at identifying the offending organism by culture and staining

  • Oral antibiotics can be tried in milder cases

  • Topical antibiotic administration is adjunctive and is also used with recurrent chronic infections

  • Warm compresses are beneficial

  • After the acute episode subsides—and in chronic cases—the nasolacrimal obstruction must be relieved surgically

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