Actinomyces canaliculitis and its surgical treatment

Abstract

The objective of this article is to describe four rare cases of Actinomyces israelii canaliculitis and their surgical treatment in a case series consisting of four cases of Actinomyces israelii canaliculitis. Patient charts were reviewed retrospectively. All four patients presented with epiphora, recurrent conjunctivitis, swelling around the superior canaliculus, and mucopurulent punctal discharge persisting despite medical treatments. Two patients with large canalicular dilation were treated with canaliculoplasty and the other two patients with minimal canalicular dilation were treated with one-snip punctoplasty. The specimens that were evacuated were sent for microbiological and histopathological examinations. The results showed that Actinomyces israelii was isolated in all patients. After medical and surgical treatment, the patients experienced resolution of signs and symptoms. The disease did not recur during the 2-4-year follow-up period. In conclusion Canaliculoplasty with canalicular intubation and one-snip punctoplasty may be safe and efficacious techniques in largely dilated canaliculum and mildly dilated canaliculum, respectively, with no demonstrable risk of post-treatment epiphora in patients with Actinomyces canaliculitis.

A case with corneal perforation due to bacterial concretion derived from lacrimal canaliculitis

“…Since topical or systemic antibiotic treatment is not effective, the most adequate treatment for canaliculitis is thought to be surgical treatment. 3 In the present case, we performed only punctoplasty and removal of the concretion, because the patient had severe dry eye. Her punctum was obstructed spontaneously several weeks after the procedure and required no further treatment.…”

“…The most effective treatment for canaliculitis is surgical extraction of the bacterial concretion. 2 , 3 …”

Actinomyces and Related Organisms in Human Infections

“…Of these, the most common infection is postoperative endophthalmitis after an ocular procedure, where A. neuii (164)(165)(166), A. meyeri (167), and "A. viscosus" (168) have been detected, while in cases of endogenous endophthalmitis, which is far less common, A. neuii (169) and A. israelii (170) have been detected. A. israelii has also been isolated from cases of postoperative keratitis (171) and primary infections of the lacrimal duct, i.e., canaliculitis (172)(173)(174). In addition, A. meyeri and A. georgiae have been found in specimens from cases of canaliculitis (172,175), while A. naeslundii was identified in a swab specimen taken from a cornea after trauma leading to keratitis (107).…”

Actinomycetes canaliculitis complicating congenital nasolacrimal duct obstruction in an infant

“…Pediatric canaliculitis is uncommon, and a review of the available English literature showed only 11 previous cases, the findings of which are tabulated in Table 1 . [ 1 3 4 5 6 7 8 9 10 ]…”