What are the causes of dacryocystitis?

Updated: Oct 08, 2019
  • Author: Grant D Gilliland, MD; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Answer

In congenital dacryocystitis, incomplete canalization of the nasolacrimal duct (specifically at the valve/membrane of Hasner) is clearly important in the pathogenesis. However, since the incidence of congenital dacryocystitis is much lower than the incidence of incomplete canalization, factors other than developmental ones appear to play a role in the pathogenesis. Neonatal infection is another important factor in the development of congenital dacryocystitis.

Both aerobic bacteria and anaerobic bacteria have been cultured from pediatric and adult patients with dacryocystitis. The most common organisms isolated from the lacrimal sacs of children with dacryocystitis include Staphylococcus aureus, Haemophilus influenzae, beta-hemolytic streptococci, mycobacterial species, and pneumococci. Methicillin-resistant Staphylococcus aureus (MRSA) is more common in patients with acute dacryocystitis than with chronic dacryocystitis.

Structural abnormalities of the midface also should be considered.

Nasal pathology that can predispose to dacryocystitis includes the following: hypertrophied inferior turbinate, deviated nasal septum, nasal polyp, and allergic rhinitis.

Obstruction of the nasolacrimal duct by a tight inferior meatus has been noted in many infants.

The etiology of dacryocystitis includes nasal disease and ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome, as outlined below.


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