Journal List > J Korean Ophthalmol Soc > v.54(4) > 1009656

Kang, Yoo, Lee, Kim, Lee, and Lee: A Case of Pseudomonas fluorescens Infection after Dacryocystorhinostomy and Silicone Tube Intubation

Abstract

Purpose

To report a case of Pseudomonas fluorescens infection following endoscopic dacryocystorhinostomy and silicone tube intubation in a healthy patient who was using steroid nasal spray. In addition, a literature review is conducted.

Case summary

A 72-year-old female patient came to our clinic with tearing and hyperemia in the right eye. Ten months prior, she had undergone endoscopic dacryocystorhinostomy and silicone tube intubation due to nasolacrimal duct obstruction in the right eye. Six months after the first operation, dacryocystorhinostomy revision with silicone tube exchange was performed due to obstruction of the nasal bony orifice. In addition, the patient was using a steroid nasal spray. On slit lamp examination, conjunctival injection, marked inflammation and punctal edema around the tube were observed. The silicone tube was removed and the tube cultured. Pseudomonas fluorescens was isolated from the tube contents. The patients was treated with topical 0.3% gatifloxacin 4 times a day, methylol cephalexin lysinate 1000 mg 3 times a day and the nasal spray was discontinued. Two weeks later, all symptoms were resolved after treatment with antibiotic treatment.

Conclusions

A case of Pseudomonas fluorescens canaliculitis which occurred in healthy patient who was using steroid nasal spray is presented with a literature review. Pseudomonas fluorescens canaliculitis can be treated by using proper antibiotics.
J Korean Ophthalmol Soc 2013;54(4):655-658

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Figure 1.
(A) Conjunctival injection, marked inflammation and edema of the punctum around the silicone tube are observed. (B) Nasal endoscopic view: osteotomy orifice is narrow and inflamed.
jkos-54-655f1.tif
Figure 2.
Two weeks after silicone tube removal, inflammation of osteotomy site is subsided (black arrow).
jkos-54-655f2.tif
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