Lacrimal Infections

Paul G. Auwaerter, M.D.
Lacrimal Infections is a topic covered in the Johns Hopkins ABX Guide.

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PATHOGENS

  • Common pathogens:
    • Haemophilus influenzae
    • Candida spp.
    • Actinomyces
    • S. aureus
    • Streptococcus species 
  • Dacryoadenitis (DA):
    • Acute: staphylococci, streptococci; rarely N. gonorrhoeae.
      • Pediatrics: EBV, mumps, CMV, enteroviruses
    • Chronic DA: usually non-infectious. If infectious, consider TB, syphilis, leprosy, cysticercosis, schistosomiasis; blastomycosis, histoplasmosis.
  • Canaliculitis (CA):
    • Acute: primary condition due to infection such as Actinomyces, Propionibacterium acnes, streptococcal species, Candida, Aspergillus, Nocardia, HSV, VZV. Many other pathogens described.
    • Secondary CA: due to punctal or intracanalicular plug; common presentation is the dry eye syndrome.
  • Dacryocystitis (DC):
    • Acute: staphylococci, streptococci, Pseudomonas aeruginosa, H. influenzae.
    • Chronic: fungal (Candida, Aspergillus), mycobacteria (TB and MOTT) and non-infectious causes (such as sarcoid).

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PATHOGENS

  • Common pathogens:
    • Haemophilus influenzae
    • Candida spp.
    • Actinomyces
    • S. aureus
    • Streptococcus species 
  • Dacryoadenitis (DA):
    • Acute: staphylococci, streptococci; rarely N. gonorrhoeae.
      • Pediatrics: EBV, mumps, CMV, enteroviruses
    • Chronic DA: usually non-infectious. If infectious, consider TB, syphilis, leprosy, cysticercosis, schistosomiasis; blastomycosis, histoplasmosis.
  • Canaliculitis (CA):
    • Acute: primary condition due to infection such as Actinomyces, Propionibacterium acnes, streptococcal species, Candida, Aspergillus, Nocardia, HSV, VZV. Many other pathogens described.
    • Secondary CA: due to punctal or intracanalicular plug; common presentation is the dry eye syndrome.
  • Dacryocystitis (DC):
    • Acute: staphylococci, streptococci, Pseudomonas aeruginosa, H. influenzae.
    • Chronic: fungal (Candida, Aspergillus), mycobacteria (TB and MOTT) and non-infectious causes (such as sarcoid).

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