Clinicobacteriological study of chronic dacryocystitis in adults.

Department of Ophthalmology, NRS Medical College, Kolkata 700014.
Journal of the Indian Medical Association 06/2008; 106(5):296-8.
Source: PubMed

ABSTRACT Chronic dacryocystitis is the inflammation of lacrimal sac, frequently caused by bacteria. Obstruction of nasolacrimal duct converts the lacrimal sac a reservoir of infection. It is a constant threat to cornea and orbital soft tissue. Moreover, it causes social embarrassment due to chronic watering from the eye. This study was conducted to find out the current clinicobacteriological profile of chronic dacryocystitis in adults. A total of 56 adult patients were selected from ophthalmology OPD. Detail history and clinical examinations were carried out. All patients underwent either dacryocystorhinostomy or dacryocystectomy. A part of the sac was collected for culture and sensitivity. This study revealed that chronic dacryocystitis is more common in females and left eye is more frequently involved than right eye. It is common among lower socioeconomic strata with habit of pond-bathing. Some form of nasal pathology like hypertrophied inferior turbinate, deviated nasal septum, nasal polyp and allergic rhinitis werefound in 19.6% of the patients. Complications of chronic dacryocystitis like conjunctivitis, corneal ulcer, acute on chronic dacryocystitis, lacrimal abscess and fistula were seen in 25.0% of these patients; 53.6% of the culture samples were positive for bacterial growth. Gram-positive organisms were most common isolate. Unlike other studies, Staphylococcus aureus (40.0%) was found to be most common Gram-positive organism, followed by Staphylococcus epidermidis (10.0%) and Steptococcus pneumoniae (10.0%). Among the Gram-negative organisms, Pseudomonas aeruginosa (16.6%) was the most common, followed by Klebsiella pneumoniae (6.6%) and Haemophilus influenzae (6.6%). Antibiotic sensitivity tests were done. Most of the organisms were resistant to penicillin. Chloramphenicol was effective against most of the Gram-positive organisms. Aminoglycosides, tobramycin in particular, was effective against Staphylococcus epidermidis. Fluoroquinolones, namely ciprofloxacin and ofloxacin were effective against Pseudomonas aeruginosa and Klebsiella pneumoniae.

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    ABSTRACT: Introduction: Dacryocystitis is an inflammation of the lacrimal sac and duct. It is an important cause of ocular morbidity, both in children and in adults.
    Journal of Clinical and Diagnostic Research 05/2012; 6(4):652-655. · 0.13 Impact Factor
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    ABSTRACT: Acute dacryocystitis, or inflammation of the lacrimal sac with lacrimal abscess, is almost always secondary to nasolacrimal duct obstruction. The standard practice for the treatment is incision and drainage because of concerns about the risks of exacerbation and spread of infection. Here we tried to evaluate primary EnDCR as a treatment for acute dacryocystitis with abscess formation. Department of ENT, Head and Neck Surgery, KVG Medical College, Sullia. This is comparative case series analysis study done in our medical college hospital during the study period 61 months from January 2007 to November 2011. 31 cases of acute dacryocystitis with lacrimal abscess managed were included in the study. 13 cases were operated primarily with EnDCR. Rest of the 18 cases was managed conventionally by incision and drainage and later by an external approach of DCR. Swelling disappeared intraoperatively in all EnDCR cases while medial canthal edema and erythema completely reduced within 2–3 days post-operatively. While in incision and drainage swelling disappeared partially intraoperatively and repeated draining was needed on the 2nd and 3rd day. The mean VAS score on first post operative day was 3.14 in group A and was 4.64 in group B. Group A had faster pain relief with 92.3% improvement in epiphora while group B had slower pain relief but epiphora remained. Mean intraoperative blood was 65 ml in group A and minimal in group B. Primary EnDCR is successful as a procedure of choice for acute dacryocystitis with abscess preventing further episodes of abscess formation and epiphora in the patients. We recommend EnDCR as the treatment of choice for acute dacryocystitis with lacrimal abscesses.
    Indian Journal of Otolaryngology and Head & Neck Surgery 08/2013; 65(2). DOI:10.1007/s12070-012-0507-8 · 0.05 Impact Factor
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    ABSTRACT: Background and Objectives: Primary acquired nasolacrimal duct obstruction (PANDO) is a common ocular problem. Clinical presentation can range from simple tearing to a life-threatening condition. The exact pathophysiology of obstruction is not completely understood. In this study, the relationship between PANDO and nasal mucosal goblet cells was investigated. Materials & Methods: In this case-control study, 15 subsequent patients with PANDO were enrolled. Patients were operated with endoscopic dacryocyctorhinostomy. A small piece of nasal mucosal biopsy sample was obtained from inferior turbinate. The samples were prepared and stained for mucin. Goblet cells were counted in the specimens. The results were compared with the nasal mucosa of 15 normal persons who were underwent rhinoplasty surgery as control group. Data were analyzed by SPSS version 16 software and were assessed using t-test, analysis of variance, and Pearson correlation test. Results: In patients group, 13 cases (86.7%) were female and 2 cases (13.3%) were male. The mean age was 42.4±14.3 years (range, 23-68 years). In control group, 9 persons (60%) were female and 6 persons (40%) were male. The mean age was 35.5±12.1 (range, 19-58 years) (P>0.05). All patients had epiphora, and 66.7% of patients had purulent discharge. Duration of symptoms ranged from 1 year to 12 years. The number of goblet cells of the nasal mucosa in patient group was significantly higher than the control group (P<0.001). Inflammation was not related to goblet cell numbers Conclusion: According to findings of this study, goblet cells have important role in inflammatory process and perhaps obstruction in nasolacrimal duct.


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