title: Aggregatibacter aphrophilus chronic lacrimal canaliculitis: a case report.
abstract: BACKGROUND
  Chronic canaliculitis is often misdiagnosed as conjunctivitis, delaying proper documentation and management. Aggregatibacter aphrophillus has not been implicated in chronic canaliculitis.
  
  
  METHODS
  We report a case of unilateral chronic epiphora associated with chronic lacrimal canaliculitis resistant to prolonged topical antibiotic treatment in a 65-year-old woman without notable medical history. Canaculotomy, curettage with removal of concretions and tubing with silicone stent for six weeks resolved this chronic infection. Culturing lacrimal secretions and concretions yielded Aggregatibacter aphrophilus in pure culture. Histological analyses showed elongated seed clusters surrounded by neutrophils. Fluorescence in Situ Hybridization confirmed the presence of bacteria in two distinctive concretions.
  
  
  CONCLUSIONS
  This first documented case of A. aphrophilus chronic lacrimal canaliculitis illustrates that optimal surgical management of chronic lacrimal canaliculitis allows for both accurate microbiological diagnosis and treatment.
authors.affiliation: Service d'Ophtalmologie, Hôpital de la Timone, Aix-Marseille-Université, Marseille, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Boulze-Pankert
authors.affiliation: Service d'Ophtalmologie, Hôpital de la Timone, Aix-Marseille-Université, Marseille, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Roux
authors.affiliation: Fédération de Microbiologie Clinique et Unité des Rickettsies, CNRS UMR 6020, Aix-Marseille Université, IHU Méditerranée Infection, Marseille, France.
authors.forename: Vanessa D
authors.initials: VD
authors.lastname: Nkamga
authors.affiliation: Fédération de Microbiologie Clinique et Unité des Rickettsies, CNRS UMR 6020, Aix-Marseille Université, IHU Méditerranée Infection, Marseille, France.
authors.forename: Frédérique
authors.initials: F
authors.lastname: Gouriet
authors.affiliation: Service d'anatomopathologie, Hôpital de la Timone, Marseille, France.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Rojat-Habib
authors.affiliation: Fédération de Microbiologie Clinique et Unité des Rickettsies, CNRS UMR 6020, Aix-Marseille Université, IHU Méditerranée Infection, Marseille, France. michel.drancourt@univ-amu.fr.|Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculté de Médecine, 27, Boulevard Jean Moulin, 13385, Marseille Cedex 5, France. michel.drancourt@univ-amu.fr.
authors.forename: Michel
authors.initials: M
authors.lastname: Drancourt
authors.affiliation: Service d'Ophtalmologie, Hôpital de la Timone, Aix-Marseille-Université, Marseille, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Hoffart
mesh_terms: D000368:Aged; D064207:Aggregatibacter aphrophilus / Q000302:isolation & purification*; D000069282:Canaliculitis / Q000382:microbiology*; D002908:Chronic Disease; D005260:Female; D006801:Humans; D013508:Ophthalmologic Surgical Procedures; D016871:Pasteurellaceae Infections / Q000382:microbiology*; D016896:Treatment Outcome
keywords: Aggregatibacter aphrophillus; Aggregatibacter aphrophilus; Canaculitis; Canaliculitis; Canaliculotomy; Case report; Haemophilus aphrophilus; diagnosis