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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