Comparative bacteriology of chronic blepharitis.

One hundred and fifteen patients with chronic blepharitis were compared with 47 normal controls. Six clinically distinct groups of blepharitis were observed: staphylococcal; seborrhoeic, alone, with associated staphylococcal superinfection, meibomian seborrhoea, or secondary inflammation of the meibomian glands; and meibomian keratoconjunctivitis (MKC). Staphylococcus aureus was isolated in appreciable frequency from the staphylococcal and the mixed staphylococcal/seborrhoeic groups in contrast to the normal and non-staphylococcal groups. Coagulase-negative Staphylococcus spp., Propionibacterium acnes, and cornyneform bacteria were the most commonly isolated bacteria from the lid for all groups. Cultures of material expressed from the meibomian glands yielded similar organisms but in reduced frequency. Testing of antibiotic susceptibility revealed Staph aureus to be usually sensitive to most commonly used ophthalmic antimicrobials except sulphonamides.     

Microbiologic spectrum of acute and chronic dacryocystitis

AIM:To report the microbiological spectrum of acute and chronic dacrocystitis.METHODS: Retrospective study on 100 patients who presented to the ophthalmic plastic clinic of a tertiary eye care center from May 2011 and April 2013 with acute and chronic dacryocystitis was reviewed for demographic and microbiological profile. The culture results and organisms isolated were recorded.RESULTS:Sixty patients had acute onset and the remaining 40 patients had chronic onset dacryocystitis. The female to male ratio was 1.78. The mean age of patients was 44y.Gram-positive organisms were the most commonly isolated accounting for 54%, and the commonest species isolated was S. aureus in 26%. Percentage of gram positive cultures was higher in chronic dacryocystitis than acute ones (82% vs 48% of positive cultures; P=0.003). Also in culture positive acute dacryocystitis, gram negative species were found in 52% of eyes but only in 18% of chronic dacryocystitis.CONCLUSION:Gram negative bacteria, culture negative samples, unusual and more virulent organisms are more common in acute dacryocystitis than chronic ones. The results of this study have significant bearing on the treatment of patients with dacrocystitis.     

Marginal corneal ulcers with acute beta streptococcal conjunctivitis and chronic dacryocystitis.

A 73-year-old woman had right dacryocystitis, intense conjunctival hyperemia and chemosis, marginal corneal ulcers, and abscesses and conjunctival cultures that were positive for beta hemolytic streptococci. A distinct lucid interval separated the peripheral corneal ulcers and infiltrates from the corneoscleral limbus. Gram stain of corneal scrapings revealed polymorphonuclear leukocytes but no bacteria, and corneal cultures were negative for bacteria. The peripheral corneal ulcers and abscesses in our patient with the lacrimal conjunctivitis of Morax clinically resembled the catarrhal ulcers found with staphylococcal blepharitis. A hypersensitivity or toxic reaction to streptococci or their products may have played a role in the development of the marginal ulcers in this patient.     

Microbiological analysis of chronic dacryocystitis

AIMS: To investigate the microbiology of specimens from patients with chronic dacryocystitis. METHODS: A total of 100 samples were obtained from the contents of the lacrimal duct in 91 consecutive patients with chronic dacryocystitis, including nine bilateral cases. These samples were cultured for aerobic and anaerobic bacteria and fungi with a routine microbiological technique. Positive cultured isolates were identified. RESULTS: A total of 180 strains were isolated from the 85 bacterial samples, including 150 strains of aerobic bacteria and 30 strains of anaerobic bacteria. Fungi were found in eight samples and actinomyces in three samples. The bacterial species that were most frequently found were Staphylococcus species, representing 34.5% of all strains, followed by Corynebacterium diphtheroides (15.5%). The sensitivity tests revealed that levo-ofloxacin and amikacin were the most effective antibiotics. CONCLUSIONS: Gram positive cocci was the predominant pathogen of chronic dacryocystitis. Levo-ofloxacin and amikacin had the best effect in vitro.     

慢性泪囊炎的手术治疗

慢性泪囊炎是鼻泪管阻塞或狭窄等引起的常见泪道病,目前无有效的药物疗法,不同疗法目的均为使用器械解除梗阻,重建引流通道.本文复习文献资料,比较了当前临床上治疗慢性泪囊炎的7种方法,认为鼻内窥镜下泪囊鼻腔吻合术效果好,微创、美观,是治疗慢性泪囊炎高效安全的方法.泪道内窥镜可在直视下对狭窄部位进行疏通,结合泪道置管,也具有很...     

Rhabdomyosarcoma masquerading as acute dacryocystitis

An 11-year-old boy presented with right medial canthal swelling. He was initially diagnosed with dacryocystitis and treated with oral antibiotics, followed by incision and drainage of a presumed lacrimal sac abscess. Rapid recurrence of the swelling led to further clinical evaluation, including a maxillofacial CT, which revealed an extensive nasal and orbital mass that was consistent with embryonal rhabdomyosarcoma on histopathologic analysis. This represents an unusual case of rhabdomyosarcoma manifesting as acute dacryocystitis. Rhabdomyosarcoma should be considered in the differential diagnosis for acquired nasolacrimal obstruction and dacryocystitis in the pediatric population.     

慢性泪囊炎致病菌分布及药物敏感性分析

目的：分析慢性泪囊炎致病菌和药物敏感性的现状,为临床合理用药提供依据。
　　方法：对171例慢性泪囊炎患者的泪囊分泌物取样,做病原菌培养鉴定及药物敏感试验。针对结果分析慢性泪囊炎致病菌菌株的检出率,慢性泪囊炎致病菌菌种种类,慢性泪囊炎的主要致病菌,大多数致病菌对何种药物敏感。结果：慢性泪囊炎的致病菌检出率为76.61%(131例)。革兰阳性球菌构成慢性泪囊炎的主要致病菌,占72.52%(95例),其中人葡萄球菌占27.48%(36例),表皮葡萄球菌占16.79%(22例),草绿色链球菌占12.98%(17例)。大多数致病菌对头孢哌酮/舒巴坦、妥布霉素、庆大霉素、左氧氟沙星敏感,其中革兰阳性球菌中对头孢哌酮/舒巴坦、庆大霉素、妥布霉素最为敏感,革兰阴性杆菌对头孢哌酮/舒巴坦、妥布霉素、左氧氟沙星最为敏感。
　　结论：人葡萄球菌成为慢性泪囊炎的主要致病菌,妥布霉素可作为治疗慢性泪囊炎的首选局部用抗生素。     

Cardiobacterium hominis-induced acute dacryocystitis and lacrimal abscess

Cardiobacterium hominis is a member of the HACEK (Haemophilus sp., Actinobacillus actinomycetemcomitans, C. hominis, Eikenella corrodens, and Kingella kingae) group commonly associated with endocarditits and is normally present in the respiratory tract. We describe the first case of acute dacryocystitis with lacrimal abscess caused by C. hominis along with a brief review of the literature. The patient responded to oral and topical ciprofloxacin after incision and drainage and awaits dacryocystorhinostomy.     

Anaerobic and aerobic bacteriology of acute conjunctivitis.

Aerobic and anaerobic cultures and clinical data were obtained from 131 patients presenting with acute conjunctivitis. Similar cultures were obtained from 60 noninflamed individuals. Anaerobes were isolated from 66 patients, 51 times in mixed culture with aerobes and 15 times (11.5%) as the only isolates. Aerobes only were recovered in 54 patients. The organisms found to be statistically significantly more commonly recovered from eyes with conjunctivitis were Staphylococcus aureus, Hemophilus influenzae, Peptostreptococcus, and Propionibacterium acnes. No statistical difference was present between the bacterial flora of the eyes with unilateral conjunctivitis when compared to their uninvolved mates in 20 cases in which only one eye was involved.     

鼻内窥镜下泪囊鼻腔造口术治疗慢性泪囊炎

目的:探讨鼻内窥镜直视下泪囊鼻腔造口术治疗慢性泪囊炎的临床疗效。方法:30例慢性泪囊炎患者,接受了鼻腔内窥镜下的泪囊鼻腔造口术。其中13例合并鼻腔病变(7例鼻中隔偏曲,6例中鼻甲肥大),同期也进行了相应的手术治疗。手术方法:使用0°或30°硬性鼻内窥镜,采用去除骨质、切除泪囊内壁的方法,实施经鼻泪囊鼻腔造口术。结果:30例患者治愈27例(占90％),好转2例(占6.7％),无效1例(占3.3％),有效率达96.7％。结论:鼻内窥镜下泪囊鼻腔造口术,可避免面部切口,术中可检查鼻内解剖状况,进行必要的处理,减少传统手术常见的失败原因,在临床上有广阔的应用前景。     

慢性泪囊炎的病理学研究进展

慢性泪囊炎是鼻泪管狭窄或阻塞继发的微生物感染,其病理改变对患者的诊断、治疗和预后都有着非常重要的意义。本文收集近几年国内外关于慢性泪囊炎的文献, 总结归纳出泪道引流系统及周围组织病理改变特征,旨在增进临床医生对该病的了解,更好地进行诊断、治疗及预后判断,也为该疾病的进一步研究提供思路。     

Facial necrotizing fasciitis following acute dacryocystitis

PURPOSE: To report a case of progressive necrotizing fasciitis of the face following acute dacryocystitis. DESIGN: Interventional case report. METHODS: A 60-year-old woman presented with left acute dacryocystitis with abscess formation that had ruptured; a small wound remained. Erythematous swelling of the left eyelid and face developed 3 days later. Clinical progression and computed tomographic findings led to the diagnosis of necrotizing fasciitis with abscess formation. Early intravenous antibiotics and repeated surgical debridements were performed. RESULTS:Soft tissue necrosis was found the fascial planes extending deep to the maxilla bone and periorbital fat. The patient was successfully treated without ocular, orbital, or facial complications. CONCLUSIONS: Necrotizing fasciitis of the eyelid and face progresses rapidly. Early diagnosis, prompt intravenous antibiotic administration, and aggressive surgical debridement will prevent the associated morbidity and mortality.