A Case of Chronic Dacryocystitis Caused by Achromobacter Xylosoxidans

PURPOSE: To report a case of chronic dacryocystitis caused by Achromobacter xylosoxidans. CASE SUMMARY: A 73-year-old female was referred to our clinic for management of chronic dacryosyctitis from which she did not to recover despite empirical therapy. A. xylosoxidans was isolated from purulent discharge. Based on the results of susceptibility testing, therapy was changed to fortified ceftazidime eye-drop 6 times a day and intravenous tazocin 4.5 g/20 ml (piperacillin 2 g/tazobactam 0.25 g) 3 times a day. All symptoms were resolved after treatment with sensitive antibiotics and external dacryocystorhinostomy. CONCLUSIONS: To our knowledge, this is the first report of A. xylosoxidans dacryocystitis. A. xylosoxidans are rare but potential pathogens which cause dacryocystitis. The cultures and sensitivity test were collected and processed to detect the presence of unusual pathogens in a case with persistent infection despite conventional treatment.

The Effect of Augmented Lateral Tarsal Strip for Paralytic Ectropion in Leprosy Patients

PURPOSE: To analyze the effect of the augmented lateral tarsal strip for the correction of the paralytic ectropion in leprosy patients. METHODS: Ten leprosy patients (16 eyelids) with exposed keratitis and lagophthalmos from paralytic ectropion underwent surgery of the augmented lateral tarsal strip. Preoperative and postoperative vertical palpebral aperture, marginal reflex distance, lagophthalmos, and anterior segment findings were recorded at 3 and 6 months after surgery. Postoperative symptomatic and functional improvements were assessed at 6 months after surgery. RESULTS: There was a significant reduction between preoperative and postoperative measurements for vertical palpebral aperture (3.1+/-0.4 mm), lower marginal reflex distance (2.1+/-1.0 mm), and lagophthalmos (2.0+/-1.2 mm). Eye irritation symptoms and lid functions were improved in all patients. In a survey, the symptomatic, functional satisfaction was achieved in 90% of patients. CONCLUSIONS: The augmented lateral tarsal strip is a sufficiently effective surgical procedure to be considered in the treatment of paralytic ectropion in leprosy patients.

Neurilemoma of the Bulbar Conjunctiva: Report of One Case

PURPOSE: To report one case of neurilemoma of the bulbar conjunctiva with a review of the relevant literature. CASE SUMMARY: A 15-year-old girl presented with a bulbar conjunctival mass in the right eye. There were no other medical or ophthalmologic problems. The patient wanted to remove the mass for cosmetic reasons. We performed an excisional biopsy and simple wound closure. The mass was composed of bipolar spindle shaped cells that were arranged in bundles and fascicles in dense fibrous tissue. Immunohistochemical staining for the S-100 protein was positive. Two months after mass excision, there was no evidence of recurrence. CONCLUSIONS: We successfully treated a case of bulbar conjunctival neuriliemoma by simple excision.