title: Acute suppurative bacterial dacryoadenitis: a case series.
abstract: 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.
authors.affiliation: South Australian Institute of Ophthalmology, North Terrace, Adelaide, SA 5000, Australia. lgoold@med.usyd.edu.au
authors.forename: Lucy A
authors.initials: LA
authors.lastname: Goold
authors.forename: Simon N
authors.initials: SN
authors.lastname: Madge
authors.forename: Alicia
authors.initials: A
authors.lastname: Au
authors.forename: Igal
authors.initials: I
authors.lastname: Leibovitch
authors.forename: Alan
authors.initials: A
authors.lastname: McNab
authors.forename: Krishna
authors.initials: K
authors.lastname: Tumuluri
authors.forename: Dinesh
authors.initials: D
authors.lastname: Selva
mesh_terms: D000208:Acute Disease; D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002648:Child; D003607:Dacryocystitis / Q000188:drug therapy* / Q000382:microbiology*; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000382:microbiology; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D008875:Middle Aged; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology*; D013492:Suppuration / Q000188:drug therapy / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents
keywords: Infection; Lacrimal gland