Canaliculitis caused by Enterobacter cloacae: report of a case.

Abstract

SUMMARY A 65-year-old man developed canaliculitis first of the left lower and later of the left upper lacrimal canaliculus. Mucoid material expressed from the upper canaliculus grew a pure culture of Enterobacter cloacae, the colonies of which had a stringy, tenacious, mucoid property consistent with the clinical findings. Treatment with topical chloramphenicol and oral ampicillin was followed by complete resolution.Canaliculitis is a problem infrequently seen by the ophthalmologist. The occurrence of canaliculitis due to actinomyces has been well described.' 2 I report here a case of canaliculitis due to Enterobacter cloacae, an organism which to my knowledge has not been described before as causing this infection. Furthermore, the microbiological characteristics of the organism explained some of the clinical features seen. Case reportA 65-year-old farmer developed swelling and tenderness of the medial canthal portion of the left -lower eyelid and epiphora. After a period of 2 months a large 'blob' of sticky, whitish material was discharged spontaneously into the-conjunctival sac, and the symptoms were relieved. Within 3 weeks, however, he noted marked swelling and tenderness (but not epiphora) affecting the medial canthal portion of the left upper eyelid, and an accumulation of mucopurulent discharge. This persisted despite therapy. From the beginning of his original symptoms treatment had consisted of topical dexamethasone 0-1% and Cortisporin (polymyxin B, neomycin sulphate, hydrocortisone) ophthalmic drops, as frequently as 3 hourly, with systemic erythromycin 250 mg. 4 times daily given in courses of 4 weeks' duration 3 times. The problem had persisted for 7 months when the patient consulted me.At the time of my first examination 7 months after onset of symptoms I noted marked swelling and

Enterobacter spp.: pathogens poised to flourish at the turn of the century

“…Enterobacter spp. have been implicated in a variety of infectious processes involving the eyes and periorbital tissues (39,124,156). Most reports, which span the last three decades, have been anecdotal.…”

Canaliculite crônica supurativa - aspectos clínicos e terapêuticos: relato de 3 casos

“…A canaliculite lacrimal é uma afecção rara que deve ser lembrada como diagnóstico diferencial nos casos de conjuntivite crônica recorrente, principalmente quando unilateral e não responsiva ao tratamento convencional (1,(4)(5)(6)(7)(8) . Os sintomas e sinais mais característicos são tumoração, hiperemia conjuntival tarsal próxima à área do canalículo afetado, saída de secreção mucopurulenta pelo ponto lacrimal dilatado e, em alguns casos, dacriolitos visíveis no seu interior.…”

“…Os sintomas e sinais mais característicos são tumoração, hiperemia conjuntival tarsal próxima à área do canalículo afetado, saída de secreção mucopurulenta pelo ponto lacrimal dilatado e, em alguns casos, dacriolitos visíveis no seu interior. Apesar disso, é importante a avaliação laboratorial completa para o diagnóstico de certeza (1,2,4,6,7) . Na maioria dos casos, a via lacrimal mantém-se pérvia (6) .…”

“…É infrequente e pode, muitas vezes, ser confundida erroneamente como conjuntivite crônica, blefarite ou hordéolo (1)(2)(3)(4)(5)(6)(7)(8) . O Actinomyces israelii é o agente etiológico mais frequente.…”

“…O Actinomyces israelii é o agente etiológico mais frequente. Este é uma bactéria Gram-positiva, anaeróbia, de difícil isolamento e identificação e que atinge o lúmen dos canalículos, formando concreções (1)(2)(3)(4)(5)(6)(7)(8) . Existem outros agentes etiológicos menos frequentes, tais como: Fusarium, Candida, Propionibacterium, Enterobacter, Nocardia e Aspergillus (6) .…”