Dacryocystitis
Updates to Article Attributes
Dacryocystitis is the inflammation of the nasolacrimal sac related to impairment in the lacrimal drainage system and superimposed infection.
Epidemiology
Dacryocystitis has a bimodal distribution: neonates due to congenital abnormalities and, when acquired, usually affect individuals older than 40 years of age.
Clinical presentation
Dacryocystitis is typically characterised by epiphora, erythema, and oedema in the region of the medial epicanthus and lacrimal puncta as the result of an infection of the nasolacrimal sac. There is often mucopurulent discharge from the puncta and associated conjunctivitis.
Pathology
Obstruction or stricture of the nasolacrimal drainage is an underlying factor.
Most cases in infants represent congenital abnormalities, such as incomplete canalisation or atresia of the nasolacrimal duct, dacryocele, andand facial clefts. Whereas in adults it is usually the result of an acquired abnormality, including:
- inflammation
/ infection/infection- rhinitis
/ sinusitis/sinusitis - paranasal sinus mucocele
- nasal septal abscess
- enlarged adenoids
- rhinitis
- anatomic variation
- enlarged turbinates
- nasal septal deviation
- tumour
- sinonasal carcinoma
- nasolacrimal duct carcinoma
- iatrogenic
/ trauma/trauma - foreign bodies
The microbiology of dacryocystitis mimics normal conjunctival flora in most instances.
In chronic dacryocystitis, there canmay be superinfection with fungal species.
Radiographic features
They typically appear as well-circumscribed round lesions centred on the lacrimal fossa with peripheral enhancement.
Treatment and prognosis
Treatment is usually with antibiotics in the acute phase. In some cases, intervention (including external dacryocystorhinostomy) may be necessary.
Chronic dacryocystitis typically requires surgery or an interventional procedure.
Complications
- abscess formation
- fistula formation
- orbital cellulitis
Differential diagnosis
Differentials on imaging include:
-
pseudodacryocystitis
- anterior ethmoidal cells sinusitis
- ethmoidal bone erosion
-
conjunctivitis
- can co-exist with dacryocystitis
-
pre-septalpreseptal orbitalcellulitscellulitis- can co-exist with dacryocystitis
-<p><strong>Dacryocystitis</strong> is the inflammation of the <a href="/articles/nasolacrimal-sac">nasolacrimal sac</a> related to impairment in the lacrimal drainage system and superimposed infection. </p><h4>Epidemiology</h4><p>Dacryocystitis has a bimodal distribution: neonates due to congenital abnormalities and, when acquired, usually affect individuals older than 40 years of age. </p><h4>Clinical presentation</h4><p>Dacryocystitis is typically characterised by epiphora, erythema, and oedema in the region of the medial epicanthus and lacrimal puncta as the result of an infection of the nasolacrimal sac. There is often mucopurulent discharge from the puncta and associated conjunctivitis.</p><h4>Pathology</h4><p>Obstruction or stricture of the nasolacrimal drainage is an underlying factor. </p><p>Most cases in infants represent congenital abnormalities, such as incomplete canalisation or atresia of the nasolacrimal duct, dacryocele, and facial clefts. Whereas in adults it is usually the result of an acquired abnormality, including:</p><ul>-<li>inflammation / infection<ul>-<li>rhinitis / sinusitis</li>- +<p><strong>Dacryocystitis</strong> is the inflammation of the <a href="/articles/nasolacrimal-sac">nasolacrimal sac</a> related to impairment in the lacrimal drainage system and superimposed infection. </p><h4>Epidemiology</h4><p>Dacryocystitis has a bimodal distribution: neonates due to congenital abnormalities and, when acquired, usually affect individuals older than 40 years of age. </p><h4>Clinical presentation</h4><p>Dacryocystitis is typically characterised by epiphora, erythema, and oedema in the region of the medial epicanthus and lacrimal puncta as the result of an infection of the nasolacrimal sac. There is often mucopurulent discharge from the puncta and associated conjunctivitis.</p><h4>Pathology</h4><p>Obstruction or stricture of the nasolacrimal drainage is an underlying factor. </p><p>Most cases in infants represent congenital abnormalities, such as incomplete canalisation or atresia of the nasolacrimal duct, dacryocele, and facial clefts. Whereas in adults it is usually the result of an acquired abnormality, including:</p><ul>
- +<li>inflammation/infection<ul>
- +<li>rhinitis/sinusitis</li>
-<li>iatrogenic / trauma</li>- +<li>iatrogenic/trauma</li>
-</ul><p>The microbiology of dacryocystitis mimics normal conjunctival flora in most instances.</p><p>In chronic dacryocystitis, there can be superinfection with fungal species.</p><h4>Radiographic features</h4><p>They typically appear as well-circumscribed round lesions centred on the lacrimal fossa with peripheral enhancement.</p><h4>Treatment and prognosis</h4><p>Treatment is usually with antibiotics in the acute phase. In some cases, intervention (including external dacryocystorhinostomy) may be necessary.</p><p>Chronic dacryocystitis typically requires surgery or an interventional procedure.</p><h5>Complications </h5><ul>- +</ul><p>The microbiology of dacryocystitis mimics normal conjunctival flora in most instances.</p><p>In chronic dacryocystitis, there may be superinfection with fungal species.</p><h4>Radiographic features</h4><p>They typically appear as well-circumscribed round lesions centred on the lacrimal fossa with peripheral enhancement.</p><h4>Treatment and prognosis</h4><p>Treatment is usually with antibiotics in the acute phase. In some cases, intervention (including external dacryocystorhinostomy) may be necessary.</p><p>Chronic dacryocystitis typically requires surgery or an interventional procedure.</p><h5>Complications </h5><ul>
-<li>pre-septal <a href="/articles/orbital-cellulits">orbital cellulits</a><ul><li>can co-exist with dacryocystitis</li></ul>- +<li>preseptal <a href="/articles/orbital-cellulits">orbital cellulitis</a><ul><li>can co-exist with dacryocystitis</li></ul>
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