Ali Mohammad Javed
Dacryology Service, L.V.Prasad Eye Institute, Hyderabad, India.
Ophthalmic Plast Reconstr Surg. 2015 Sep-Oct;31(5):341-7. doi: 10.1097/IOP.0000000000000472.
To review and summarize the symptomatology, microbiology, special clinical entities, management, complications, and outcomes of pediatric acute dacryocystitis.
The author performed a PubMed search of all articles published in English on acute dacryocystitis. Pediatric subpopulations of these articles were reviewed along with the scant literature of direct references to neonatal and pediatric acute dacryocystitis. Data reviewed included demographics, presentations, microbiological work up, management, complications, and outcomes.
Acute dacryocystitis is not very common in the pediatric age groups and occurs mostly as a complication of congenital nasolacrimal duct obstruction. The age of onset is usually in the neonatal period with a female preponderance. The clinical spectrum ranges from classic pediatric acute dacryocystitis to meningitis. Staphylococcus aureus is the commonest isolate. Occasionally acquired etiologies and rare organisms like Pantoea sp., Epstein-Barr Virus, and Sporothrix are implicated in the etiopathogenesis. The diagnosis is usually clinical aided by laboratory investigations. Better antibiotics, well-established laboratory techniques and surgical modalities, and improved patient care logistics have contributed to good outcomes; however, complications are still being noted although infrequently.
Pediatric acute dacryocystitis is a distinct entity with unique features of its own. It is a serious infection that warrants careful evaluation and immediate management. In the era of antibiotic resistance, microbiological work up of Pediatric acute dacryocystitis is very useful for subsequent treatment. Surgical challenges in the pediatric age group are distinct and the outcomes are good if standard protocols are followed.
回顾并总结小儿急性泪囊炎的症状学、微生物学、特殊临床情况、治疗、并发症及预后。
作者在PubMed上检索了所有以英文发表的关于急性泪囊炎的文章。对这些文章中的儿科亚组进行了回顾，并参考了少量直接提及新生儿和小儿急性泪囊炎的文献。所回顾的数据包括人口统计学、临床表现、微生物学检查、治疗、并发症及预后。
急性泪囊炎在儿科年龄组中并不常见，主要作为先天性鼻泪管阻塞的并发症出现。发病年龄通常在新生儿期，女性居多。临床谱从典型的小儿急性泪囊炎到脑膜炎不等。金黄色葡萄球菌是最常见的分离菌。偶尔，获得性病因以及罕见微生物如泛菌属、爱泼斯坦-巴尔病毒和申克孢子丝菌也与发病机制有关。诊断通常依靠临床并辅以实验室检查。更好的抗生素、成熟的实验室技术和手术方式以及改善的患者护理流程有助于取得良好的预后；然而，尽管并发症并不常见，但仍有发现。
小儿急性泪囊炎是一种具有独特特征的独特疾病。它是一种严重的感染，需要仔细评估并立即治疗。在抗生素耐药的时代，小儿急性泪囊炎的微生物学检查对后续治疗非常有用。儿科年龄组的手术挑战独特，如果遵循标准方案，预后良好。
