Lacrimal Infections

PATHOGENS

• Common pathogens:
  
  • Haemophilus influenzae
  • Candida spp.
  • Actinomyces
  • S. aureus
  • Streptococcus species
• Dacryoadenitis (DA):
  
  • Acute: staphylococci, streptococci; rarely N. gonorrhoeae.
    • Pediatrics: EBV, mumps, CMV, enteroviruses
  • Chronic DA: usually non-infectious and may be idiopathic; consider IgG-4-related disorders. If infectious, consider TB, syphilis, leprosy, cysticercosis, schistosomiasis, sporotrichosis, blastomycosis, and histoplasmosis.
• Canaliculitis (CA):
  
  • Acute: Primary conditions are caused by infections such as Actinomyces, Propionibacterium acnes, streptococcal species, Candida, Aspergillus, Nocardia, HSV, and VZV.
    • Many other pathogens are described.
  • Secondary CA: due to punctal or intracanalicular plug; common presentation is dry eye syndrome.
• Dacryocystitis (DC):
  • Acute: staphylococci, streptococci, Pseudomonas aeruginosa, H. influenzae.
  • Chronic: fungal (Candida, Aspergillus), mycobacteria (TB and MOTT) and non-infectious causes (such as sarcoid).