Subject(s)
Actinomyces/isolation & purification , Actinomycosis/diagnosis , Actinomycosis/microbiology , Actinomycosis/pathology , Adult , Bacteriological Techniques , Corneal Ulcer/diagnosis , Corneal Ulcer/microbiology , Corneal Ulcer/pathology , Dacryocystitis/diagnosis , Dacryocystitis/microbiology , Dacryocystitis/pathology , Female , Humans , Lacrimal Apparatus/microbiology , Lacrimal Apparatus/pathology , Lacrimal Apparatus Diseases/diagnosis , Lacrimal Apparatus Diseases/microbiology , Lacrimal Apparatus Diseases/pathology , MicroscopyABSTRACT
Infectious canaliculitis is one of the least common causes of epiphora in elderly. Actinomyces israelii is the most common causative organism encountered in the vast majority of patients who present with persistent purulent conjunctivitis. In rare cases however, other opportunistic organisms may be the etiological agents of infectious canaliculitis. Here we report a case of 80-years-old-man who presented with 1-year history of tearing associated with discharge from his left eye. Examination revealed pouting of mucupurulent discharge from his left lower punctum with patent lacrimal system on irrigation. Culture revealed Eikenella corrodens and the patient was treated with topical antibiotics resulting in full resolution of his symptoms. To the best of our knowledge, there have been only two previous case reports describing canaliculitis caused by Eikenella corrodens. We report this case to emphasize that Eikenella corrodens should be considered in the differential diagnosis of canaliculitis
Subject(s)
Humans , Male , Lacrimal Apparatus Diseases/microbiology , Diagnosis, Differential , Administration, Topical , Lacrimal Apparatus Diseases/drug therapy , Conjunctivitis, BacterialABSTRACT
Objetivo: Descrever o quadro clínico de um paciente com canaliculite por Actinomyces israelii e discutir as suas principais características clínicas, assim como o seu manejo terapêutico. Relato de caso: Paciente de 68 anos, sexo masculino, com história de conjuntivite crônica unilateral, rebelde ao tratamento clínico. Ao exame clínico inicial apresentava edema e hiperemia em canto medial da pálpebra inferior esquerda, dilatação e edema do ponto lacrimal inferior, havendo drenagem de secreção mucopurulenta por este, à expressão do saco lacrimal. O exame bacteriológico do material colhido foi positivo para o Actinomyces israelii, tendo sido instituído o tratamento cirúrgico. Discussão: A canaliculite por Actinomyces israelii é uma afecção ocular rara, porém, com um quadro clínico típico. Os autores ressaltam a grande freqüência com que esta doença é mal diagnosticada e conduzida levando, na maioria das vezes, a insucessos terapêuticos e retorno dos sintomas.