Acute dacryocystitis in pediatric patients and frequency of nasolacrimal duct patency

Alaboudi, Abdulmajeed; Al-Shaikh, Osama; Fatani, Dalal; Alsuhaibani, Adel H.

doi:10.1080/01676830.2020.1717548

Cited by 9 publications

(11 citation statements)

References 26 publications

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“…The most common and concerning complication associated with CNLDO is acute dacryocystitis. 18 , 33 Ffooks reported that the incidence of acute dacryocystitis as a complication of CNLDO was approximately 1.6% (7/440 patients). 33 In our study, acute dacryocystitis was present in 1.8% of patients (2/108) in the intervention group; it was not present in the conservative treatment group.…”

Section: Discussionmentioning

confidence: 99%

“…Benefits of early probing intervention include the prevention of complications such as acute dacryocystitis, periorbital cellulitis, and inflammation around the ocular area; such intervention also helps children and caregivers to avoid the burden of CNLDO symptoms. 16 , 18 However, to balance these benefits with the procedural and general anesthesia risks, as well as the high rate of spontaneous resolution in patients with uncomplicated cases, thorough discussions with caregivers are necessary.…”

Section: Introductionmentioning

confidence: 99%

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Age-Specific Outcomes of Conservative Approach and Probing for Congenital Nasolacrimal Duct Obstruction

Lekskul¹,

Preechaharn²,

Jongkhajornpong³

et al. 2022

OPTH

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Purpose To evaluate the resolution rate of lacrimal sac massage and the efficacy of primary probing among different age groups of patients with CNLDO in Thai population. Patients and Methods Retrospectively reviewed the medical records of patients younger than 10 years of age who had been diagnosed with CNLDO, from January 1st, 2011, to October 31st, 2021. Patients were divided into two groups. The conservative treatment group comprised patients who had received Crigler’s maneuver and topical antibiotic when indicated; the intervention group comprised patients who had received probing. Results There were 469 patients in the conservative treatment group and 108 patients in the probing group. In the conservative treatment group; the patients were categorized into five groups according to age: 0 to <6 months, 6 to <12 months, 12 to <18 months, 18 to <24 months, and ≥24 months. The resolution rates for these age groups were 99.25%, 96.23%, 64.71%, 50%, and 62.07%, respectively. The rate of spontaneous resolution was significantly associated with patient age (p <0.01). In the intervention group; the patients were categorized into four age groups according to age: 0 to <12 months, 12 to <24 months, 24 to <36 months, and ≥36 months. The success rates of primary probing for these age groups were 92.86%, 89.29%, 85.71%, and 94.12%, respectively. The success rate of primary probing was not significantly associated with patient age (p >0.05). Conclusion The Crigler’s maneuver is a safe and highly effective procedure for the management of CNLDO in patients of multiple ages, particularly patients less than 12 months of age. According to the high spontaneous resolution rate and the low rate of complications, the clinicians may delay surgical intervention when desired.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Age-Specific Outcomes of Conservative Approach and Probing for Congenital Nasolacrimal Duct Obstruction

Lekskul¹,

Preechaharn²,

Jongkhajornpong³

et al. 2022

OPTH

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“…Clinically, pain and tenderness increase and the infection may extend and diffuse to adjacent tissues. For this reason, antibiotic therapy (systemic and topical) seems justified and is recommended as first-line therapy for acute dacryocystitis [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast to abscesses due to eyelid infections or sinusitis that often require surgery [ 10 , 12 ], invasive therapy for pediatric dacryocystitis is controversial. It is reserved for chronic, persistent dacryocystitis, or children presenting with congenital nasolacrimal duct obstruction, which is not the case in EBV-related cases [ 10 , 11 ]. Percutaneous puncture and drainage is suggested if dacryocystitis is complicated with an adjacent abscess.…”

Section: Discussionmentioning

confidence: 99%

Epstein–Barr virus-related dacryocystitis: a case report

et al. 2022

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Background and objective Acute dacryocystitis is an atypical and rare manifestation of pediatric mononucleosis still widely underdiagnosed in clinical practice. We report this rare condition and describe challenges in its diagnosis and treatment on the basis of a presented case. Case presentation A 6-year-old Caucasian girl without any ophthalmic history was admitted for right preseptal cellulitis requiring intravenous antibiotic therapy. During hospitalization, she developed a fluctuating lump in the nasolacrimal region which resembled an abscess, both clinically and radiologically. There was no spontaneous purulent discharge. Serology was positive for acute mononucleosis and Epstein–Barr virus-related dacryocystitis was diagnosed. Following multidisciplinary discussion, she was treated conservatively with digital lacrimal sac massages and intravenous antibiotic therapy with an excellent outcome. Discussion This rare form of Epstein–Barr virus is poorly documented in the literature, and thus barely known. As initial symptoms are nonspecific (rhinitis, fever, eyelid edema and erythema lack of purulent discharge, and moderate bilateral cervical lymphadenopathy), diagnosis is often difficult. Nevertheless, differentiating between dacryocystitis and abscess is crucial to select the appropriate treatment and avoid unnecessary, potentially harmful surgery. Conservative management of dacryocystitis appears to be the gold standard of treatment. Conclusion Acute dacryocystitis in children free of ophthalmic history should raise suspicion of primary Epstein–Barr virus infection. With conservative treatment, prognosis appears to be excellent; therefore, surgery should be avoided as much as possible.

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“…Early recognition and quick management for acute dacryocystitis are necessary to prevent complications due to infection spreading and achieve excellent outcomes [ 109 ]. Oral antibiotics may be sufficient in uncomplicated cases.…”

Section: Introductionmentioning

confidence: 99%

Developments in pediatrics in 2020: choices in allergy, autoinflammatory disorders, critical care, endocrinology, genetics, infectious diseases, microbiota, neonatology, neurology, nutrition, ortopedics, respiratory tract illnesses and rheumatology

et al. 2021

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Acute dacryocystitis in pediatric patients and frequency of nasolacrimal duct patency

Cited by 9 publications

References 26 publications

Age-Specific Outcomes of Conservative Approach and Probing for Congenital Nasolacrimal Duct Obstruction

Age-Specific Outcomes of Conservative Approach and Probing for Congenital Nasolacrimal Duct Obstruction

Epstein–Barr virus-related dacryocystitis: a case report

Developments in pediatrics in 2020: choices in allergy, autoinflammatory disorders, critical care, endocrinology, genetics, infectious diseases, microbiota, neonatology, neurology, nutrition, ortopedics, respiratory tract illnesses and rheumatology

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