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Cast-forming Actinomyces israelii canaliculitis.
Aust N Z J Ophthalmol. 1997 Nov; 25(4):301-3.AN

Abstract

BACKGROUND

Primary chronic canaliculitis is an uncommon disease usually caused by Actinomyces israelii (streptothrix). Actinomyces israelii is a cast-forming Gram-positive anaerobe that is difficult to isolate and identify. We present a case that demonstrates the typical clinicopathological presentation of this unusual condition and discuss management options.

METHODS AND RESULTS

A 10-year-old girl presented with a 6 month history of intermittent 'conjunctivitis' and discharge from her 'pouted' left lower punctum. Microbiology confirmed probable A. israelii infection, but topical treatment failed. Exploration under anaesthesia revealed a canalicular diverticulum and three canaliculiths. Histological examination of the canaliculiths demonstrated that they consisted of solid casts of Actinomyces. Punctoplasty, removal of the casts, and adjunct antibiotic therapy resulted in resolution of the canaliculitis.

CONCLUSIONS

Primary chronic canaliculitis should be considered in any patient who presents with chronic or recurrent conjunctivitis and the eyelid should be inspected for a discharging and 'pouting' punctum. Failure of the condition to resolve on topical treatment requires surgical exploration of the canalicular system and removal of any casts. Extensive surgery is not always required.

Authors+Show Affiliations

Department of Ophthalmology, Christchurch Hospital, New Zealand.No affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

9395835

Citation

McKellar, M J., and N S. Aburn. "Cast-forming Actinomyces Israelii Canaliculitis." Australian and New Zealand Journal of Ophthalmology, vol. 25, no. 4, 1997, pp. 301-3.
McKellar MJ, Aburn NS. Cast-forming Actinomyces israelii canaliculitis. Aust N Z J Ophthalmol. 1997;25(4):301-3.
McKellar, M. J., & Aburn, N. S. (1997). Cast-forming Actinomyces israelii canaliculitis. Australian and New Zealand Journal of Ophthalmology, 25(4), 301-3.
McKellar MJ, Aburn NS. Cast-forming Actinomyces Israelii Canaliculitis. Aust N Z J Ophthalmol. 1997;25(4):301-3. PubMed PMID: 9395835.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cast-forming Actinomyces israelii canaliculitis. AU - McKellar,M J, AU - Aburn,N S, PY - 1997/12/13/pubmed PY - 1997/12/13/medline PY - 1997/12/13/entrez SP - 301 EP - 3 JF - Australian and New Zealand journal of ophthalmology JO - Aust N Z J Ophthalmol VL - 25 IS - 4 N2 - BACKGROUND: Primary chronic canaliculitis is an uncommon disease usually caused by Actinomyces israelii (streptothrix). Actinomyces israelii is a cast-forming Gram-positive anaerobe that is difficult to isolate and identify. We present a case that demonstrates the typical clinicopathological presentation of this unusual condition and discuss management options. METHODS AND RESULTS: A 10-year-old girl presented with a 6 month history of intermittent 'conjunctivitis' and discharge from her 'pouted' left lower punctum. Microbiology confirmed probable A. israelii infection, but topical treatment failed. Exploration under anaesthesia revealed a canalicular diverticulum and three canaliculiths. Histological examination of the canaliculiths demonstrated that they consisted of solid casts of Actinomyces. Punctoplasty, removal of the casts, and adjunct antibiotic therapy resulted in resolution of the canaliculitis. CONCLUSIONS: Primary chronic canaliculitis should be considered in any patient who presents with chronic or recurrent conjunctivitis and the eyelid should be inspected for a discharging and 'pouting' punctum. Failure of the condition to resolve on topical treatment requires surgical exploration of the canalicular system and removal of any casts. Extensive surgery is not always required. SN - 0814-9763 UR - https://www.unboundmedicine.com/medline/citation/9395835/Cast_forming_Actinomyces_israelii_canaliculitis_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0814-9763&date=1997&volume=25&issue=4&spage=301 DB - PRIME DP - Unbound Medicine ER -