Purchase this article with an account.
R.A. Zaldivar, G.B. Bartley, E.A. Bradley; Microbiologic and Pathologic Features of Primary Canaliculitis . Invest. Ophthalmol. Vis. Sci. 2005;46(13):5065.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Purpose:To evaluate the microbiologic and pathologic features of primary canaliculitis. Methods: We searched a computerized database to identify cases of canaliculitis seen at the Mayo Clinic from 1993–2004. Cases were also identified from the files of two of the authors. Canaliculitis was defined as documented mucopurulent punctal regurgitation on palpation of the canaliculus associated with eyelid thickening or eyelid erythema, or if a classic pouting punctum was described. Data abstracted from the charts included clinical presentation, treatment, microbiology, pathology, and patient outcome. Results: Five hundred thirty potentially relevant patient records were identified. Twenty met our definition of canaliculitis. There were 13 females and 7 males with an average age of 60 years. The median duration of symptoms was 4.5 months. Eleven of 13 specimens submitted for culture yielded at least one organism. The most common organisms identified were Actinomyces and Streptococcus species. Propionibacterium species, Fusobacterium, Eikenella corrodens, Proteus mirabilis, and Morganella morganii were also seen. More than half of the positive specimens were polymicrobial. Although the majority of culture results showed facultative anaerobes or anaerobes in conjunction with aerobic organisms, two specimens yielded solely aerobic organisms (streptococcus in one case and staphylococcus in the other). Inappropriate medium for actinomyces was used in three cases, but organisms were nonetheless identified in two of these three cases using standard culture methods. Sensitivities were performed on four of the 11 culture–positive cases, with antibiotic resistance (sulfa) reported in one case of abiotrophia/granulicatella. Five specimens were submitted for both microbiologic and pathologic evaluation. The morphologic features of actinomyces were identified in all the pathology specimens. Conclusions: The microbiology of canaliculitis seen at our institution is usually polymicrobial and composed of anaerobes or facultative anaerobes. Proteus mirabilis, not previously reported as causing canaliculitis, was identified in two cases. Resistance to antibiotics was rare in our patient population.
This PDF is available to Subscribers Only