Presumed acute suppurative bacterial dacryoadenitis with concurrent severe acute respiratory syndrome coronavirus-2 infection

Abstract

Acute suppurative bacterial dacryoadenitis (ASBD) was not reported to occur following severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. We are presenting a unique case of concurrent presumed ASBD with SARS-CoV-2 infection. A 23-year-old previously healthy male presented with right upper eyelid swelling and pain over the lacrimal gland area for 3 days. Before his visit, the patient was tested positive for SARS-CoV-2 infection after experiencing mild flu-like symptoms, despite being vaccinated 2 months ago. He was found to have clinical and radiological features highly suggestive of ASBD with concurrent SARS-CoV-2 infection. He was admitted and initiated on systemic and topical antibiotic, followed by incision and drainage of an abscess collection. The patient showed dramatic clinical improvement with no recurrent signs of infection during the follow-up period. This acute dacryoadenitis is presumed to represent a secondary bacterial infection possibly aided by immune-related factors that may coexist in SARS-CoV-2-positive patients.

Update on coronavirus disease 2019: Ophthalmic Manifestations and Adverse Reactions to Vaccination

“…Viral infection, particularly Ebstein-Barr virus, is the most common etiology in children and young adults 148 . Dacryoadenitis related to COVID-19 infection has been reported as isolated case reports 147–150 . The mean age of patients in the published literature was 22.2 years (median 23 y, 6 mo–36 y) with symptoms developing at a mean of 15.2 days (median 12 d, 7–30 d) after the diagnosis/onset of symptoms of COVID-19.…”

“…The patient improved after a course of IV antibiotics and methylprednisolone. Almater et al 150 reported a case of presumed acute suppurative bacterial dacryoadenitis 10 days after the diagnosis of COVID-19.…”