Actinomycosis: A Cause of Chronic Conjunctivitis Often Overlooked

Abstract

Chronic canaliculitis is an inflammation of the lacrimal canaliculus. Inflammation of lacrimal canaliculus can occur secondary to dacryocystitis, but the most common cause is infection. 1 Bacteria, fungi and viruses can cause infection. The most common presenting symptom of canaliculitis is chronic conjunctivitis. Actinomyces species is classically cited as the most common organism causing canaliculitis. 2-4 Concretions in the lower palpebral conjunctiva/fornix with conjuctivitis can also be the presenting symptom of Actinomyces infection. 5 We hereby report two cases of chronic conjunctivitis, one with canaliculitis and the other with palpebral concretions, both were positive for Actinomyces and responded to topical 5% cefazoline eyedrops. Case Report-1 A 50 year old male presented to us with complaints of chronic irritation,watering and occasional redness of the right eye since past 8 months. He was prescribed various topical antibiotic drops but he did not respond to any of them. On examination, his vision was 6/6 in both eyes. Examination of the right eye revealed a tender swelling in the medial one third of the right lower lid with congestion of adjacent lower palpebral conjunctiva and pouting lower punctum (Figure 1