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Pediatric Acute Dacryocystitis

Ali, Mohammad Javed F.R.C.S

Ophthalmic Plastic and Reconstructive Surgery: September/October 2015 - Volume 31 - Issue 5 - p 341–347
doi: 10.1097/IOP.0000000000000472
Major Review

Purpose: To review and summarize the symptomatology, microbiology, special clinical entities, management, complications, and outcomes of pediatric acute dacryocystitis.

Methods: The author performed a PubMed search of all articles published in English on acute dacryocystitis. Pediatric subpopulations of these articles were reviewed along with the scant literature of direct references to neonatal and pediatric acute dacryocystitis. Data reviewed included demographics, presentations, microbiological work up, management, complications, and outcomes.

Results: Acute dacryocystitis is not very common in the pediatric age groups and occurs mostly as a complication of congenital nasolacrimal duct obstruction. The age of onset is usually in the neonatal period with a female preponderance. The clinical spectrum ranges from classic pediatric acute dacryocystitis to meningitis. Staphylococcus aureus is the commonest isolate. Occasionally acquired etiologies and rare organisms like Pantoea sp., Epstein-Barr Virus, and Sporothrix are implicated in the etiopathogenesis. The diagnosis is usually clinical aided by laboratory investigations. Better antibiotics, well-established laboratory techniques and surgical modalities, and improved patient care logistics have contributed to good outcomes; however, complications are still being noted although infrequently.

Conclusions: Pediatric acute dacryocystitis is a distinct entity with unique features of its own. It is a serious infection that warrants careful evaluation and immediate management. In the era of antibiotic resistance, microbiological work up of Pediatric acute dacryocystitis is very useful for subsequent treatment. Surgical challenges in the pediatric age group are distinct and the outcomes are good if standard protocols are followed.

Acute dacryocystitis in pediatrics.

Dacryology Service, L.V.Prasad Eye Institute, Hyderabad, India

Accepted for publication March 2, 2015.

Mohammad Javed Ali receives royalties from Springer for his textbook “Principles and Practice of Lacrimal Surgery’.

Address correspondence and reprint requests to Mohammad Javed Ali, F.R.C.S., Dacryology Service, L.V.Prasad Eye Institute, Road No 2, Banjara Hills, Hyderabad, 500034, India. E-mail:

© 2015 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.