1/6. Acute dacryocystitis as a presenting sign of pediatric leukemia.PURPOSE: To report acute dacryocystitis with preseptal cellulitis as the presenting sign of leukemia in a child. methods: Case report and literature review. RESULTS: During the initial evaluation of a 17-month-old child with epiphora, left lower eyelid swelling, and a tender left medial canthal mass, a complete blood cell count demonstrated pancytopenia. bone marrow biopsy disclosed replacement of normal cellular architecture with a dense infiltrate of leukocyte blast forms. dna analysis disclosed a translocation between chromosome 10 and 11, consistent with the diagnosis of nonlymphocytic leukemia. Although the adjacent lower eyelid cellulitis responded to intravenous antibiotics, lacrimal sac distention decreased only after chemotherapy was initiated. CONCLUSIONS: dacryocystitis with preseptal cellulitis can be a presenting sign of leukemia. This blood malignancy should be considered in patients whose leukocyte counts do not correlate with their clinical presentation.- - - - - - - - - - ranking = 1keywords = dacryocystitis (Clic here for more details about this article) |
2/6. Superior ophthalmic vein thrombosis in a patient with dacryocystitis-induced orbital cellulitis.A 71-year-old-man presented with chronic left-sided epiphora and a 5-day history of progressive left orbital swelling that had started with a "bump" on the left side of his nose. Orbital CT revealed left-sided preseptal and postseptal inflammation, along with marked thickening of the left superior ophthalmic vein. Orbital MRI with gadolinium enhancement and fat suppression revealed a low-intensity signal in the left superior ophthalmic vein, consistent with a superior ophthalmic vein thrombosis. There was no cavernous sinus involvement. A diagnosis was made of left-sided dacryocystitis-induced orbital cellulitis and superior ophthalmic vein thrombosis. Treatment consisted of intravenous vancomycin, followed by early dacryocystorhinostomy and postoperative intravenous dexamethasone. Anticoagulation was not used. Within 1 week after surgery, the orbital congestion had dramatically improved. Though rare, isolated superior ophthalmic vein thrombosis can be a harbinger of cavernous sinus thrombosis; therefore, early detection is the key to avoiding cavernous sinus thrombosis.- - - - - - - - - - ranking = 1keywords = dacryocystitis (Clic here for more details about this article) |
3/6. orbital cellulitis secondary to dacryocystitis following blepharoplasty.The authors report what they believe to be the first case of a blepharoplasty procedure complicated by an acute postoperative dacryocystitis that precipitated orbital cellulitis. The patient had a preoperatively compromised nasolacrimal drainage system. Because acute dacryocystitis and resulting orbital cellulitis are potential postoperative complications of a blepharoplasty, blepharoplasty candidates should undergo preoperative evaluation of their nasolacrimal drainage systems.- - - - - - - - - - ranking = 1.2keywords = dacryocystitis (Clic here for more details about this article) |
4/6. Primary dacryocystitis causing orbital cellulitis.A patient was examined who had acute dacryocystitis that caused true orbital cellulitis. The symptoms of the cellulitis receded after treatment with cephalothin sodium and hot compresses. A dacryocystorhinostomy was performed three weeks later. Delay of the surgery until the acute episode had resolved was probably responsible for the good surgical results.- - - - - - - - - - ranking = 1keywords = dacryocystitis (Clic here for more details about this article) |
5/6. Bilateral candida albicans dacryocystitis with facial cellulitis.candida albicans rarely infects the lacrimal drainage system. This paper describes a case of bilateral C. albicans dacryocystitis following midfacial trauma. The patient presented with recurrent facial cellulitis and a fistula opening onto the cheek. The condition was controlled only after bilateral dacryocystorhinostomy along with amphotericin b therapy. This appears to be the first reported case in which the lacrimal sacs acted as a reservoir for microorganisms causing recurrent facial cellulitis.- - - - - - - - - - ranking = 1keywords = dacryocystitis (Clic here for more details about this article) |
6/6. 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.- - - - - - - - - - ranking = 2.6keywords = dacryocystitis (Clic here for more details about this article) |