Dacryocystitis: Difference between revisions
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Tintinalli 7th ed, p. 764; UpToDate | Tintinalli 7th ed, p. 764; UpToDate | ||
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Revision as of 22:31, 1 December 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