View source for Dacrocystitis

==Background==
*Acute or chronic inflammation and bacterial infection of the lacrimal sac
**Most common pathogens: Strep. pneumoniae, staph. aureus, staph. epidermidis, h. influenzae
*Most common in children
*Often after viral URI
*Complications: peri-orbital cellulitis, orbital cellulitis

==Clinical Features==
*Mucopurulent material expressed from nasolacrimal sac
*Erythema and edema between medial canthus and nasal bridge

==Diagnosis==
*Physical exam
*May culture purulent material

==DDx==
*Dacryocele
*Dacryostenosis
*Dacryoadenitis

==Treatment==
*Oral clindamycin for 7-10 days
*If ill appearing - IV cephalosporin (cefuroxime 50 mg/kg IV Q8h or cefazolin 33 mg/kg IV Q6H) or clindamycin (10 mg/kg IV Q8H)
**If MRSA suspected - Vancomycin 10-13 mg/kg IV Q6-8 h
*Chronic dacryocystitis - topical ABX (fluoroquinolone or erythromycin)
*Consult ophthalmology

==See Also==
[[Red Eye (by Sx)]]

==Sources==
Tintinalli 7th ed, p. 764; UpToDate