title: Lacrimal gland ductulitis caused by probable Actinomyces infection.
abstract: OBJECTIVE
  To describe the clinical characteristics and management of a group of patients who had chronic mucopurulent conjunctivitis that was probably due to Actinomyces infection of the lacrimal gland ductules.
  
  
  METHODS
  A retrospective, interventional case series.
  
  
  METHODS
  Seven patients (2 male; 29%) between 34 and 52 years of age (mean, 48.7 years; median, 49 years) who presented to the lacrimal clinic.
  
  
  METHODS
  Surgical excision of the infective focus (6 cases) or fenestration and expression of infective debris (1 case) from the affected lacrimal gland ductule--typically the most inferolateral of the ductules.
  
  
  METHODS
  The clinical features of this previously unrecognized cause of chronic conjunctivitis and its response to treatment.
  
  
  RESULTS
  All cases settled rapidly after surgery. There was often a major delay in diagnosis, with the patients having symptoms for between 2 and 42 months before referral (mean, 13.3 months; median, 9 months); 5 patients received prolonged or ineffectual topical medical therapy before referral.
  
  
  CONCLUSIONS
  Infective lacrimal gland ductulitis, commonly from Actinomyces infection, should be considered in patients with unexplained chronic mucopurulent conjunctivitis; the condition settles rapidly with surgery.
  
  
  BACKGROUND
  Proprietary or commercial disclosure may be found after the references.
authors: Moorfields Eye Hospital, London, United Kingdom.
authors: Graham
authors: G
authors: Hay-Smith
authors: Geoffrey E
authors: GE
authors: Rose
mesh_terms: D000190:Actinomyces / Q000302:isolation & purification*; D000196:Actinomycosis / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D000328:Adult; D002908:Chronic Disease; D003234:Conjunctivitis, Bacterial / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000382:microbiology* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome