What are the treatment options for acute dacryocystitis with orbital cellulitis?

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

The treatment of dacryocystitis depends upon the clinical manifestations of the disease.

Acute dacryocystitis with orbital cellulitis

Acute dacryocystitis with orbital cellulitis necessitates hospitalization with intravenous (IV) antibiotics. Ampicillin-sulbactam, ceftriaxone, and moxifloxacin are possible antibiotic alternatives. Vancomycin should be considered for suspected MRSA infection. [12]

Appropriate neuroimaging studies should be obtained, and surgical exploration and drainage should be performed for focal collections of pus.

IV empiric antimicrobial therapy for penicillin-resistant Staphylococcus (nafcillin or cloxacillin) should be initiated immediately.

Blood cultures and cultures of the lacrimal secretions should be obtained prior to antibiotic therapy.

Treatment with warm compresses may aid in resolution of the disease.

A pointing nasolacrimal sac abscess should be lanced. A stent can be placed in the abscess cavity to allow irrigation of antibiotic solution.


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