Dacryoadenitis associated with Acanthamoeba keratitis.
OBJECTIVE
To report the incidence of dacryoadenitis as a symptom associated with Acanthamoeba keratitis.


METHODS
We investigated all cases of Acanthamoeba keratitis (20 patients and 21 eyes) diagnosed and treated at Tokyo Dental College, Ichikawa General Hospital, Ichikawa, Japan, between May 1, 1994, and November 30, 2005. We recorded the incidence of dacryoadenitis diagnosed using clinical signs of lacrimal gland swelling and pain on pressure, computed tomography, magnetic resonance imaging, and histopathologic analysis.


RESULTS
Eight eyes (38%) of 8 patients had dacryoadenitis simultaneously with Acanthamoeba keratitis. Dacryoadenitis was diagnosed using histopathologic analysis and computed tomography in 1 patient, histopathologic analysis and magnetic resonance imaging in 1, magnetic resonance imaging in 2, and clinical signs alone in 4. Histopathologic examination in 2 patients revealed moderate infiltration of lymphocytes and plasma cells in the lacrimal gland compatible with dacryoadenitis. No Acanthamoeba organisms were found in the lacrimal gland. The standard protocol for Acanthamoeba keratitis was performed without particular treatment of dacryoadenitis in all patients. Lacrimal gland swelling improved after a mean of 10 weeks (range, 4-17 weeks) in conjunction with symptoms of keratitis; however, 1 patient (patient 1) required levator muscle surgery and blepharoplasty for residual ptosis.


CONCLUSIONS
Dacryoadenitis is a clinical finding associated with Acanthamoeba keratitis.
Tomita
Machiko
M
Department of Ophthalmology, Tokyo Dental College, Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa, Chiba, Japan.
Shimmura
Shigeto
S
Tsubota
Kazuo
K
Shimazaki
Jun
J
D015823:Acanthamoeba Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D003263:Contact Lenses, Hydrophilic / Q000469:parasitology; D003607:Dacryocystitis / Q000175:diagnosis / Q000188:drug therapy / Q000469:parasitology*; D004209:Disposable Equipment; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D015994:Incidence; D007765:Lacrimal Apparatus / Q000469:parasitology / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D000981:Antiprotozoal Agents