Dacryocystitis: Difference between revisions
(Created page with "==Background== *Acute or chronic inflammation and bacterial infection of the lacrimal sac **Most common pathogens: Strep. pneumoniae, staph. aureus, staph. epidermidis, h. inf...") |
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*Most common in children | *Most common in children | ||
*Often after viral URI | *Often after viral URI | ||
*Complications: | *Complications: [[Periorbital Cellulitis]], [[Orbital Cellulitis]] | ||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 17:11, 30 September 2013
Background
- Acute or chronic inflammation and bacterial infection of the lacrimal sac
- Most common pathogens: Strep. pneumoniae, staph. aureus, staph. epidermidis, h. influenzae
- Most common in children
- Often after viral URI
- Complications: Periorbital Cellulitis, Orbital Cellulitis
Clinical Features
- Mucopurulent material expressed from nasolacrimal sac
- Erythema and edema between medial canthus and nasal bridge
Diagnosis
- Physical exam
- May culture purulent material
DDx
- Dacryocele
- Dacryostenosis
- Dacryoadenitis
Treatment
- Oral clindamycin for 7-10 days
- If ill appearing - IV cephalosporin (cefuroxime 50 mg/kg IV Q8h or cefazolin 33 mg/kg IV Q6H) or clindamycin (10 mg/kg IV Q8H)
- If MRSA suspected - Vancomycin 10-13 mg/kg IV Q6-8 h
- Chronic dacryocystitis - topical ABX (fluoroquinolone or erythromycin)
- Consult ophthalmology
Sources
Tintinalli 7th ed, p. 764; UpToDate