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Acute suppurative bacterial dacryoadenitis: a case series
  1. Lucy A Goold1,
  2. Simon N Madge1,2,
  3. Alicia Au3,
  4. Igal Leibovitch4,
  5. Alan McNab3,
  6. Krishna Tumuluri5,
  7. Dinesh Selva1
  1. 1South Australian Institute of Ophthalmology, Adelaide, Australia
  2. 2Department of Ophthalmology, Hereford County Hospital, Hereford, UK
  3. 3Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
  4. 4Division of Oculoplastic and Orbital Surgery, Department of Ophthalmology, Tel Aviv Medical Centre, Tel-Aviv University, Tel Aviv, Israel
  5. 5Department of Ophthalmology, Westmead Hospital, Sydney, Australia
  1. Correspondence to Dr L A Goold, Department of Ophthalmology and Visual Sciences, Royal Adelaide Hospital, North Terrace, Adelaide SA 5000, Australia; lgoold{at}


Background We present a series of patients with acute suppurative bacterial dacryoadenitis and review the clinical presentation, microbiology, treatment options and outcome.

Methods A multicentre, retrospective, case series review of patients with a clinical diagnosis of acute bacterial suppurative dacryoadenitis (ASBD). Records were examined to obtain information regarding patient demographics, presenting symptoms and signs, radiology, microbiology, management, outcomes and follow-up.

Results 11 patients (9 men, 2 women; mean age 43.9 years, range: 6–82 years) were included. Average time to presentation was 2.8 days, and predisposing conditions were found in 45% of cases. Common presenting symptoms were eyelid swelling, pain, redness and diplopia, and common signs were ptosis, discharge and restriction of eye movements. The most common causative bacteria were Staphylococcus aureus and skin flora. Lacrimal gland swelling was universally seen on CT, with globe indentation of displacement in 27% of cases. Intravenous antibiotics were used in 91% of cases, which subsequently resolved over an average period of 9.7 days. Those with abscess formation (n=2) required incision and drainage.

Conclusions ASBD is a rare condition that resolves quickly if managed appropriately. Underlying anatomical, infectious or inflammatory conditions should be investigated, and skin commensals should be covered with the instigation of antibiotic therapy.

  • Infection
  • Lacrimal gland

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