September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Critical exam findings and culture results that correlate with inpatient hospitalization in the setting of Acute Infectious Dacryoadenitis
Author Affiliations & Notes
  • Matthew Zhang
    Ophthalmology, Vanderbilt Eye Institute, Nashville , Tennessee, United States
    Ophthalmology and Visual Sciences, Vanderbilt University, Nashville, Tennessee, United States
  • Sarah Tanaka
    Ophthalmology, Vanderbilt Eye Institute, Nashville , Tennessee, United States
  • Matthew Hollar
    Ophthalmology, Vanderbilt Eye Institute, Nashville , Tennessee, United States
  • Viraj Mehta
    Ophthalmology, Vanderbilt Eye Institute, Nashville , Tennessee, United States
  • Behin Barahimi
    Ophthalmology, Vanderbilt Eye Institute, Nashville , Tennessee, United States
  • Footnotes
    Commercial Relationships   Matthew Zhang, None; Sarah Tanaka, None; Matthew Hollar, None; Viraj Mehta, None; Behin Barahimi, None
  • Footnotes
    Support  Research to Prevent Blindness Grant
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 695. doi:
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    • Get Citation

      Matthew Zhang, Sarah Tanaka, Matthew Hollar, Viraj Mehta, Behin Barahimi; Critical exam findings and culture results that correlate with inpatient hospitalization in the setting of Acute Infectious Dacryoadenitis. Invest. Ophthalmol. Vis. Sci. 2016;57(12):695.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Acute Infectious Dacryoadenitis (AID) is a potentially life-threatening ophthalmic condition that is understudied. We performed a retrospective, observational clinical study that identified culture results and critical signs on physical examination which correlated with whether patients did or did not require inpatient hospitalization in the setting of AID.

Methods : A retrospective chart review was performed of Vanderbilt Hospital records for patients of all ages who carried an ICD9 code of 375.01 (acute dacryoadenitis) between the years 1998 and 2015, and in whom at least 1 year of ophthalmology follow-up was available. A total of 20 patients met entry criteria. Twelve patients with inpatient hospitalization and eight patients treated as outpatients were reviewed. The two-tailed Fisher’s exact test and Chi-squared test were used to draw statistical comparisons between categories of this study.

Results : A total of 20 patients with AID were identified. Twelve patients with AID were admitted for inpatient management and intravenous antibiotics. Eight patients were managed on an outpatient basis. Fornix cultures were obtained in thirteen AID subjects. There were six patients that had culture-confirmed Staphylococcus aureus (SA), and another seven patients had mixed flora or no growth. All six SA-positive patients presented with critical signs on examination, defined as purulent discharge and/or extraocular movement deficits. SA culture-positivity correlated with the presence of purulent discharge (p=0.006) and extraocular movement deficits (p=0.02). The likelihood of inpatient hospitalization also correlated positively with the presence of purulent discharge (p=0.0009) and extraocular movement deficits (p=0.0004). Finally, SA culture-positivity correlated with likelihood of inpatient hospitalization (p=0.0419)

Conclusions : In patients with AID, our findings suggest that the presence of purulent discharge and extraocular movement deficits correlated with SA culture-positivity. Also, SA culture-positivity, presence of purulent discharge, and extraocular movement deficits each separately correlated strongly with the likelihood of inpatient hospitalization.This is the first study that correlates culture results and critical signs on examination with likelihood of inpatient hospitalization in the setting of AID.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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