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Mica Bergman, Jesse berry; Microbiologic Analysis of Dacryocystitis at LAC + USC Medical Center. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):4071.
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To investigate the microbiologic profile of dacryocystitis at a major county hospital in Southern California.
IRB approved retrospective review of dacryocystorhinostomy (DCR) operations performed from 1/1/2000 - 11/3/2014. Patients with a diagnosis of dacryocystitis in whom at least one culture was performed during the course of their care were included in this study.
Sixteen cases of dacryocystitis were identified in fifteen patients. Of these, eleven underwent culture one time, four underwent culture two times, and one underwent culture three times, yielding a total of 22 cases. Of the 22 cases, 19 cases had a positive yield, 12 cases were monomicrobial, 6 cases were bimicrobial, and 1 case was trimicrobial. In lacrimal sacs undergoing culture two or more times, the same organism was found in multiple specimens two out of five times. In total, there were 14 isolates of gram-positive cocci, 10 isolates of gram-negative bacilli, 1 isolate of gram-negative diplococci, and 2 fungal isolates. The most commonly identified bacteria was klebsiella pneumoniae (4 isolates), followed by staphylococcus aureus and streptococcus viridans (3 isolates each). Bacteria thought to be nonpathogenic (eg staphylococcus epidermidis and diphtheroids) were excluded.
This series demonstrates that there is a wide range of pathogens implicated in dacryocystitis in our county hospital in Southern California. The most commonly isolated bacteria were klebsiella pneumoniae, staphylococcus aureus, and streptococcus viridans. One third of patients had polymicrobial culture results. Given that gram-negative and gram-positive pathogens were found in similar numbers, it is advisable to treat initially with a broad-spectrum antibiotic.
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