Clinicobacteriological study of chronic dacryocystitis in adults.

Chronic dacryocystitis is the inflammation of lacrimal sac, frequently caused by bacteria. Obstruction of nasolacrimal duct converts the lacrimal sac a reservoir of infection. It is a constant threat to cornea and orbital soft tissue. Moreover, it causes social embarrassment due to chronic watering from the eye. This study was conducted to find out the current clinicobacteriological profile of chronic dacryocystitis in adults. A total of 56 adult patients were selected from ophthalmology OPD. Detail history and clinical examinations were carried out. All patients underwent either dacryocystorhinostomy or dacryocystectomy. A part of the sac was collected for culture and sensitivity. This study revealed that chronic dacryocystitis is more common in females and left eye is more frequently involved than right eye. It is common among lower socioeconomic strata with habit of pond-bathing. Some form of nasal pathology like hypertrophied inferior turbinate, deviated nasal septum, nasal polyp and allergic rhinitis werefound in 19.6% of the patients. Complications of chronic dacryocystitis like conjunctivitis, corneal ulcer, acute on chronic dacryocystitis, lacrimal abscess and fistula were seen in 25.0% of these patients; 53.6% of the culture samples were positive for bacterial growth. Gram-positive organisms were most common isolate. Unlike other studies, Staphylococcus aureus (40.0%) was found to be most common Gram-positive organism, followed by Staphylococcus epidermidis (10.0%) and Steptococcus pneumoniae (10.0%). Among the Gram-negative organisms, Pseudomonas aeruginosa (16.6%) was the most common, followed by Klebsiella pneumoniae (6.6%) and Haemophilus influenzae (6.6%). Antibiotic sensitivity tests were done. Most of the organisms were resistant to penicillin. Chloramphenicol was effective against most of the Gram-positive organisms. Aminoglycosides, tobramycin in particular, was effective against Staphylococcus epidermidis. Fluoroquinolones, namely ciprofloxacin and ofloxacin were effective against Pseudomonas aeruginosa and Klebsiella pneumoniae.

Bacteriological profile in chronic dacryocystitis.

A study was conducted to see the bacteriological profile in 172 cases of chronic dacryocystitis attending eye outpatients department of Midnapore Medical College and Hospital and NRS Medical College and Hospital, Kolkata. The patients underwent clinical examination of the eyes and lacrimal system, with particular attention to drainage system. The culture and sensitivity test was done from the material, which regurgitated through the punctum following pressure on sac. Out of 172 cases, 66(38.4%) were found with epiphora, 44 cases (25.9%) of epiphora with mass, 8 cases (4.6%) with epiphora mass with cellulitis and in 54 (31.4%) with chronic conjunctivitis. Bactriologically, 142 patients (82.5%) were revealed with pure culture, mixed culture in 18 cases (10.5%) and no growth of organism in 12 cases (7.0%). Staphylococcus aureus was found primary pathogen in disease process. Candida albicans were seen in 4 cases (2.3%).