Dacryocystitis

- Unilateral inflammation of lacrimal sac due to obstruction of the flow of tears from the sac.

- May progress to periorbital/orbital cellulitis.

Acute

- Collect exudate from lacrimal punctum for C&S.

 

   Infants:

  • 50% resolve spontaneously by 12-18 months.
  • If chronic consider probing (after 1 year of age).

   Adults (usually > 40 years):

  • Usually requires systemic therapy.
  • Chronic or recurrent cases usually require dacryocystorhinostomy.
Usual Pathogens

S. aureus
S. pneumoniae
H. influenzae
S. pyogenes
P. aeruginosa

Infants

Empiric Therapy

Dose

Duration
Massage lacrimal sac

Adults

Empiric Therapy Dose Duration
Warm compresses
+    
Cloxacillin 500mg PO qid 7 days
or    
Cephalexin 500mg PO qid 7 days