Treatment-Refractory Canaliculitis

[摘要] A 62-year-old male patient complained of a several-month history of unilateral tearing, occasional discharge, and permanent erythema of the medial lower eyelid. A variety of unsuccessful attempts at treatment with local antibiotic eyedrops had previously been undertaken. Treatment-resistant conjunctivitis should prompt consideration of canaliculitis as a rare differential diagnosis if there is painful swelling in the region of the (mostly upper) canaliculus. Chemosis is occasionally visible at the lacrimal point (left image). Successful treatment is based on canaliculotomy with careful and complete curettage of the dacryoliths (right image), without which long-term resolution cannot occur. Since this minor intervention, the treated patient has been, and remains, asymptomatic. In most cases, there is microbiological or histopathological evidence of actinomycetes. These are a gram-positive bacterial species with elongated, sometimes branching cells and anaerobic growth.

[学科分类] 医学（综合）