TY - JOUR T1 - Clinico-Microbiological Profile in Dacryocystitis at Tertiary Care Teaching Hospital AU - Fatima, Samra AU - Fatima, Khizra AU - Chowdary, Sowmya AU - Eram, Sadiya AU - Khan, Siddique JO - Research Journal of Medical Sciences VL - 17 IS - 7 SP - 991 EP - 995 PY - 2023 DA - 2001/08/19 SN - 1815-9346 DO - 10.59218\makrjms.2023.991.995 UR - https://makhillpublications.co/view-article.php?doi=10.59218\makrjms.2023.991.995 KW - Dacryocystitis KW - lacrimal sac KW - inflammation KW - culture KW - sensitivity AB -

Dacryocystitis is an in ammation of the lacrimal sac, which usually occurs because of obstruction of the nasolacrimal duct. The obstruction may be an idiopathic in ammatory stenosis (primary acquired nasolacrimal duct obstruction) or may be secondary to trauma, infection in ammation, neoplasm or mechanical obstruction (secondary acquired lacrimal drainage obstruction). Obstruction of the nasolacrimal duct leading to stagnation of tears in a pathologically closed lacrimal drainage system can result in dacryocystitis. The microbiology of dacryocystitis may differ in acute and chronic infections. Acute dacryocystitis is often caused by Gram-negative rods. In chronic dacryocystitis, mixed bacterial isolates are more commonly found with the predominance of Streptococcus pneumoniae and Staphylococcus spp. This is a prospective study, we included patients with dacryocystitis in the department of ophthalmology and microbiology at tertiary care teaching hospital over a period of 1 year. Patients were diagnosed as acute or chronic dacryocystitis based on their history, signs and symptoms. Chronic dacryocystitis was diagnosed as persistent epiphora and regurgitation of mucoid or mucopurulent material on pressure over the sac area or during irrigation of the lacrimal drainage system. Besides that when the lacrimal sac area showed manifestation of pain, redness and swelling, it would be diagnosed as acute dacryocystitis. Nasolacrimal duct obstruction (NLDO) was diagnosed according to the lacrimal passage irrigation test results. A total of 70 patients with dacryocystitis were enrolled in the study, which included 21 males (30%) and 49 females (70%). The least age group were under 10 years (1.4%) and maximum were 51-60 years (28.5%). In this population, 27 patients had right-side involvement and 29 of them had left-side dacryocystitis. In addition, there were 14 patients with bilateral dacryocystitis. In terms of type, 21 patients (30%) were encountered with acute dacryocystitis and 49 of them (70%) had chronic form. In this study, the dominant strain in the culture media was considered as an effective microbial agent in the pathogenesis of dacryocystitis and antibiogram was performed on this dominant strain. It was also assumed that if two strains with equal colony count were found in the medium both of them must be introduced as causative agents of dacryocystitis and antibiogram must be performed for each of them separately but this situation did not occur in any of our patients. The most common bacterial isolate in dacryocystitis, prevailing in this geographical area is Staphylococcus (gram positive) followed by Pseudomonas, Pneumococcus and Staph epidermidis. Combination of Vancomycin and 3rd generation cephalosporin can be used as empirical therapy when the culture reports are awaited.

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