The microbiological profile of lacrimal abscess: two decades of experience from a tertiary eye care center

Introduction: Dacryocystitis is the inflammatory condition of the lacrimal sacwhich occur in acute and chronic form. Chronic dacryocystitis is commonly encountered, accounting for 87.1% of Epiphorawhich causes social embarrassment due to chronic watering from the eye. Understanding the antibiogram for micro organism causing inflammation of lacrimal sac can be useful in choosing the best antimicrobial. Hence the present study was done to evaluate the clinical profile and antibiogram of acute and chronic dacryocystitis. Method: A prospective observational study was done in patients with acute or chronic dacryocystitis attending ophthalmology OPD. Those fulfilling the eligibility criteria were enrolled in the study. Samples were collected from all the cases and were sent to microbiology lab for gram staining, culture and sensitivity. Result: 100 patients of dacryocystitis were enrolled, chronic dacryocystitis was found common than the acute dacryocystitis, along with a female (middle age group) preponderance. The main presenting symptom was watering (89%) followed by discharge (47%), swelling (34%), pain (23%) and tenderness (23%). Gram positive organisms (72.86%) were most commonly isolated. Among the Gram-positive organisms, Staph. aureus (37.14%) while Pseudomonas among Gram negative were the common isolate. Vancomycin and tobramycin are highly active against all Gram positive, tobramycin, gentamycin, fluoroquinolones and cephalosporins are found to be very active against Gram negative bacteria. Conclusion: The most common bacterial isolate in dacryocystitis, prevailing in this geographical area is Staphylococcus (Gram positive) followed by Pseudomonas, Pneumococcus and Staph epidermidis. Combination of Vancomycin and 3 rd generation cephalosporin can be used as empirical therapy when the culture reports are awaited.

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“…Similar findings but with different prevalence were reported by few other studies [20,23]. In present study, organisms are [15,28,32,33,34].…”

Section: Discussionsupporting

confidence: 89%

Clinico-Microbiological profile in dacryocystitis: a prospective observational study

et al. 2018

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“…Dacryocystitis is more common in the females. 4 In the present series, incidence of dacryocystitis is 66% in females and 34% in males. The sex ratio of female:male being about 2:1.…”

Section: Discussionmentioning

confidence: 45%

A Clinical and Bacteriological Study of Chronic Dacryocystitis

Mallampalli¹,

Erra²

2017

jebmh

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BACKGROUNDChronic dacryocystitis is a very common clinical condition encountered in day-to-day ophthalmic practice. Chronic dacryocystitis and its various complications are known to every ophthalmologist. The word dacryocystitis as such suggests inflammation of lacrimal sac and its duct.The aim of the present study is to study the bacteriological and microbiological pattern of dacryocystitis. MATERIALS AND METHODSWe have conducted a prospective case study in patients attending the Outpatient Department of Ophthalmology in Government General Hospital, Kakinada, during the period of 2014 to 2016. The study was done in 50 patients to evaluate clinical and bacteriological pattern of chronic dacryocystitis. RESULTSOut of 50 cases of dacryocystitis studied bacteriological report shows 56% cases report is sterile, 4% cases coagulase positive, 6% cases coagulase negative, 4% cases positive for diplococcus pneumonia, 8% cases showed positive for streptococcus viridians, 8% cases showed positive for Klebsiella, 4% for pseudomonas and 2% for mixed results. CONCLUSIONIncidence of the bacterial infection of the lacrimal passage as revealed in the present studies quiet high.

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“…Dacrocystitis might present in two forms. Acute dacryocystitis is an acute inflammation of the lacrimal sac with tenderness and erythema of the overlying tissues and 23% of eyes might present with lacrimal abscess [12,13].…”

Section: Discussionmentioning

confidence: 99%

Clinicobacterial and histopathological study of chronic dacryocystitis

Saxena¹,

Gupta²,

Gupta

et al. 2017

Int J Med Res Rev

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Introduction: Diseases of lacrimal drainage system account for nearly 3% of visits to eye clinic. Chronic dacryocystitis is a frequently encountered disorder among these patients. The aim of this study was to identify the organisms responsible and to determine the antibiotic susceptibility pattern of the bacterial isolates from conjunctiva and nasal mucosa in cases of chronic dacryocystitis and comparing with lacrimal sac specimen. Material and Methods: Prospective longitudinal study carried out in 40 cases suffering from chronic dacryocystitis. After complete history and local examination of the cases, the sac was excised and examined histopathologically in pathology department. Swabs of the smear were taken in all cases were cultured and antibiotic sensitivity was done. The results were analyzed by using mean, median and the Chi-square (χ2) test Results: The maximum incidence of the disease has been in the 4th and 5th decade of life, females were more predominantly affected than the males. The epithelial hypertrophy was the most common histological finding i.e 77.5%, the second common was squamous metaplasia followed by goblet cell formation. Culture and antibiotic sensitivity was done in all cases; out of these the maximum cases were found to be sterile i.e.55%. The bacteria which have been isolated in the 45% cases in order of frequency were staphylococcus 20%, streptococcus12.5% and pneumococcus 12.5% respectively. Conclusion: Majority of the chronic dacryocystitis cases are caused by Staphylococcus, streptococcus and pneumococcus. Amoxyclav and 3rd generation cephalosporins can be used to treat chronic dacryocystitis. The epithelial hypertrophy and Non-specific chronic inflammation with fibrosis is indeed the most commonly reported histopathological finding in lacrimal sac wall biopsy specimens. Microbiological analysis and antimicrobial susceptibility pattern is mandatory for the selection of a specific antimicrobial therapy and to the control of further resistance development of bacterial strains.

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The microbiological profile of lacrimal abscess: two decades of experience from a tertiary eye care center

Cited by 40 publications

References 16 publications

Clinico-Microbiological profile in dacryocystitis: a prospective observational study

Clinico-Microbiological profile in dacryocystitis: a prospective observational study

A Clinical and Bacteriological Study of Chronic Dacryocystitis

Clinicobacterial and histopathological study of chronic dacryocystitis

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