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M. Tomita, S. Shimmura, T. Sumi, K. Tsubota, J. Shimazaki; Dacryoadenitis Associated With Acanthamoeba Keratitis . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2615.
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Purpose: Acanthamoeba keratitis is known to cause various clinical findings including severe anterior and posterior scleritis, anterior uveitis, cataract, glaucoma, lid edema, and reactive pseudoptosis. The purpose of this study is to report a series of patients with dacryoadenitis associated with acanthamoeba keratitis. Methods: We investigated all cases of acanthamoeba keratitis (18 cases, 19 eyes) diagnosed and treated at Tokyo Dental College Ichikawa General Hospital, Japan, between May 1994 and November 2004. We recorded the incidence and clinical findings of dacryoadenitis diagnosed by computed tomography (CT), magnetic resonance imaging (MRI) and histopathology. Results: Six eyes of 6 cases (32%) presented with dacryoadenitis simultaneously with acanthamoeba keratitis. Dacryoadenitis was diagnosed by histopathological findings and CT in 1 case, MRI in 3 cases, and clinical signs of lacrimal gland swelling in another 2 cases. Histopathological examination of 1 case revealed moderate infiltration of lymphocytes and plasma cells in the lacrimal gland compatible with dacryoadenitis. No acanthamoeba organisms were found in the lacrimal gland. Standard protocol for acanthamoeba keratitis was done without particular treatment for dacryoadenitis in all cases. Lacrimal gland swelling improved in conjunction with symptoms of keratitis, however, 1 case required blepharoplasty for residual ptosis. Conclusions: Dacryoadenitis is a clinical finding associated with acanthamoeba keratitis.
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