Dacryocystite aiguë sur une primo-infection mononucléosique

Delbet, C.; Dang, N. Pham; Mondié, J.-M.; Barthélémy, Isabelle

doi:10.1016/j.stomax.2010.06.004

Cited by 5 publications

(6 citation statements)

References 6 publications

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“…The main goal is to unclog the lacrimal sac and prevent a potential infection. Conservative management (digital massages, intravenous antibiotic therapy, topical antibiotics with or without systemic corticoids) seems to be the consensus approach among specialists [ 1 , 2 , 5 , 7 , 8 , 13 ]. It is of note that antibiotic therapy with aminopenicillins is not indicated if EBV infection is clearly documented because, in 70–90% of these cases, a rash can appear.…”

Section: Discussionmentioning

confidence: 99%

“…It is of note that antibiotic therapy with aminopenicillins is not indicated if EBV infection is clearly documented because, in 70–90% of these cases, a rash can appear. Pathogenesis of this secondary cutaneous eruption is not fully understood and the causality with antibiotic therapy is debated [ 3 , 5 ]. Literature is scarce but recommends avoiding surgery in the absence of complications such as preseptal cellulitis, ethmoiditis, cavernous sinus thrombosis, meningitis, and abscess [ 1 , 2 , 5 , 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…Pathogenesis of this secondary cutaneous eruption is not fully understood and the causality with antibiotic therapy is debated [ 3 , 5 ]. Literature is scarce but recommends avoiding surgery in the absence of complications such as preseptal cellulitis, ethmoiditis, cavernous sinus thrombosis, meningitis, and abscess [ 1 , 2 , 5 , 7 , 8 ]. Invasive treatment seems to be inadequate owing to the risk of cutaneous fistula or postoperative stenosis [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…While the majority of infections are subclinical, some present the typical triad of fever, lymphadenopathy, and pharyngitis. Only a few patients develop hepato- or splenomegaly [ 3 – 5 ]. While these are the classical manifestations, many others manifestations have been described [ 2 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the pediatric population, acute dacryocystitis by obstruction of the nasolacrimal duct (due to nasal mucosal hypertrophy) is an atypical presentation of mononucleosis [ 2 , 5 , 7 – 9 ]. This case report aims to familiarize physicians with this uncommon presentation.…”

Section: Introductionmentioning

confidence: 99%

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Epstein–Barr virus-related dacryocystitis: a case report

et al. 2022

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Background and objective Acute dacryocystitis is an atypical and rare manifestation of pediatric mononucleosis still widely underdiagnosed in clinical practice. We report this rare condition and describe challenges in its diagnosis and treatment on the basis of a presented case. Case presentation A 6-year-old Caucasian girl without any ophthalmic history was admitted for right preseptal cellulitis requiring intravenous antibiotic therapy. During hospitalization, she developed a fluctuating lump in the nasolacrimal region which resembled an abscess, both clinically and radiologically. There was no spontaneous purulent discharge. Serology was positive for acute mononucleosis and Epstein–Barr virus-related dacryocystitis was diagnosed. Following multidisciplinary discussion, she was treated conservatively with digital lacrimal sac massages and intravenous antibiotic therapy with an excellent outcome. Discussion This rare form of Epstein–Barr virus is poorly documented in the literature, and thus barely known. As initial symptoms are nonspecific (rhinitis, fever, eyelid edema and erythema lack of purulent discharge, and moderate bilateral cervical lymphadenopathy), diagnosis is often difficult. Nevertheless, differentiating between dacryocystitis and abscess is crucial to select the appropriate treatment and avoid unnecessary, potentially harmful surgery. Conservative management of dacryocystitis appears to be the gold standard of treatment. Conclusion Acute dacryocystitis in children free of ophthalmic history should raise suspicion of primary Epstein–Barr virus infection. With conservative treatment, prognosis appears to be excellent; therefore, surgery should be avoided as much as possible.

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