title: Dacryocystitis secondary to intranasal cocaine abuse: a case report and literature review.
abstract: OBJECTIVE
  To report a case of dacryocystitis secondary to intranasal cocaine abuse and to review the literature on the effects of cocaine on sinus, nasal and lacrimal structures.
  
  
  METHODS
  Case report and literature review.
  
  
  RESULTS
  A 33-year-old male presented with unilateral epiphora and discharge, and clinical examination was consistent with dacryocystitis. He had a 2-year history of intranasal cocaine use. Computed tomography revealed extensive bilateral intranasal and sinus destruction, consistent with cocaine abuse. He was treated with antibiotics followed by dacryocystorhinostomy with silicone intubation. He had 2 recurrences of dacryocystitis and underwent one additional lacrimal surgery.
  
  
  CONCLUSIONS
  Cocaine abuse and its accompanying intranasal and sinus destruction should be considered when determining the etiology of nasolacrimal obstruction and dacryocystitis. A medical and social history with specific questions about drug abuse may be useful. Computed tomography is helpful in delineating damage to the sinuses, nose and lacrimal system. Management with antibiotics and dacryocystorhinostomy surgery may result in resolution of symptoms.
authors.affiliation: Department of Pathology, Beth Israel Deaconess Medical Center, Boston , Massachusetts , USA and.
authors.forename: Felicia D
authors.initials: FD
authors.lastname: Allard
authors.forename: Eric U
authors.initials: EU
authors.lastname: Yee
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Freitag
mesh_terms: D000281:Administration, Intranasal; D000328:Adult; D000779:Anesthetics, Local / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D003042:Cocaine / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D003131:Combined Modality Therapy; D003607:Dacryocystitis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000628:therapy; D003608:Dacryocystorhinostomy; D024841:Fluoroquinolones / Q000627:therapeutic use; D000077734:Gatifloxacin; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D009301:Nasolacrimal Duct / Q000000981:diagnostic imaging / Q000187:drug effects*; D014057:Tomography, X-Ray Computed
chemical_list: D000779:Anesthetics, Local; D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D017963:Azithromycin; D003042:Cocaine; D000077734:Gatifloxacin