Sheikh Osama Al, Thaqib Rawan Al, Sulaiman Naif Al, Al-Sharif Eman M
Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia.
Department of Ophthalmology, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
Saudi J Ophthalmol. 2021 Nov 17;35(3):263-265. doi: 10.4103/SJOPT.SJOPT_110_21. eCollection 2021 Jul-Sep.
Canaliculitis is defined as infection of the canalicular part of the lacrimal system. Despite usual presenting clinical characteristics such as pouting of the lacrimal punctum, discharge, and redness at the medial canthus area, it is usually misdiagnosed and overlooked. The presence of punctal ulceration and tissue necrosis is an uncommon presentation in these patients. We report a case of a 35-year-old female with a 3-day history of left lower eyelid medial swelling, tenderness, and discharge. She was found to have left lower eyelid diffuse conjunctival injection and swelling involving the lower lacrimal punctum with whitish necrotic tissue. The patient was taken to the minor treatment room and debridement of the necrotic tissue was done and swabs were taken for culture and sensitivity. The punctum was found to be open with deroofing of the proximal canalicular system due to the severe nature of the infection; this was followed by irrigation using moxifloxacin and povidone-iodine. The patient was started on systemic antibiotics, topical antibiotic eye drops, and povidone-iodine sticks to clean the affected area. Few days later, the microbiology results revealed infection by , and the patient was improving gradually until she had complete resolution of the infection.
泪小管炎被定义为泪液系统泪小管部分的感染。尽管其通常具有一些典型的临床特征，如泪小点外翻、分泌物增多以及内眦部发红，但它通常会被误诊和忽视。泪小点溃疡和组织坏死在这些患者中是不常见的表现。我们报告一例35岁女性病例，其有3天的左眼下睑内侧肿胀、压痛和分泌物增多的病史。检查发现她左眼下睑结膜弥漫性充血，累及下泪小点并伴有白色坏死组织。患者被带到小治疗室，对坏死组织进行了清创，并采集拭子进行培养和药敏试验。由于感染严重，发现泪小点开放，近端泪小管系统顶部被破坏；随后用莫西沙星和聚维酮碘进行冲洗。患者开始使用全身抗生素、局部抗生素眼药水以及聚维酮碘棒来清洁感染区域。几天后，微生物学结果显示感染了 ，患者逐渐好转，直至感染完全消退。 （原文此处“infection by ”后内容缺失）
