acute dacryocystitis
Introduction
Introduction to acute dacryocystitis Acute arachnoidulitis (acutedacryocystitis) is mostly caused by chronic dacryocystitis, but it is also the case of acute primary bacterial infection. Common pathogenic microorganisms include pneumococci, staphylococcus aureus, beta-hemolytic streptococcus, and influenza viruses. It is realized that the lacrimal sac is highly red, swollen, hot and painful. The severer is red and swollen in the same side of the nose. The lymph nodes in the ear and submandibular are swollen, tender, with elevated body temperature and general malaise. Acute dacryocystitis should not be washed during the acute onset of the lacrimal duct. It should be applied locally. If there is a sense of fluctuation, the pus should be cut open. The whole body should be actively applied antibiotics. After a week of redness, swelling and heat pain, the lacrimal sac nasal anastomosis can be performed. It will return to normal. basic knowledge The proportion of illness: 0.06% - 0.08% Susceptible people: no specific population Mode of infection: non-infectious Complications: swelling, abscess
Cause
Cause of acute dacryocystitis
Anatomical factors (25%):
There are many variations of the nasolacrimal duct, and some are relatively narrow. Especially for patients with low nasal or facial stenosis, the diameter of the tube is small, and the mucosa is slightly swollen to cause obstruction. During the developmental period, the nasolacrimal duct is incomplete or the mucosal folds are formed, the inner diameter of the lumen is too small, and the mucosal swelling can completely block it.
Systemic infection (30%):
Such as influenza, scarlet fever, diphtheria, tuberculosis, etc., may be through blood-borne transmission. Influenza (referred to as influenza) is an acute respiratory infection caused by influenza virus, and it is also a disease that is highly contagious and spreads rapidly. It is mainly transmitted by droplets in the air, contact between people or contact with contaminated objects.
Excessive secretion of tears and retention of tears (15%):
The tension of the lacrimal sac can be weakened, and at the same time it is chronic irritability, the resistance of the lacrimal sac wall is reduced, and it is susceptible to inflammation by bacteria.
Foreign body (20%):
Laryngeal inflammation can also be caused by eyelashes entering from the punctum or from the nasal cavity into the nasolacrimal duct.
Prevention
Acute dacryocystitis prevention
Acute dacryocystitis should not be washed during the acute onset of the lacrimal duct. It should be applied locally. If there is a sense of fluctuation, the pus should be cut open. The whole body should be actively applied antibiotics. After a week of redness, swelling and heat pain, the lacrimal sac nasal anastomosis can be performed. It will return to normal.
Complication
Acute dacryocyst complications Complications swelling abscess
1. The lacrimal sac is red, swollen, hot, painful, and may affect the upper and lower jaws or cheeks. The lymph nodes in the lower jaw and the ear may be swollen, which may be accompanied by elevated body temperature and general malaise;
2. After a few days, the swelling and softening form an abscess, fluctuation, rupture, inflammation subsided, often forming a lacrimal sac, and the sacral obstruction can be acute.
Symptom
Acute symptoms of dacryocystitis common symptoms, tears, pre-auricular lymphadenopathy, conjunctival congestion, lacrimal gland enlargement, fever, lacrimal gland inflammation
1. There is often a history of chronic dacryocystitis.
2. The lacrimal sac is highly red, swollen, hot and painful. The severed part is red and swollen in the same side of the nose. The lymph nodes in the ear and submandibular are swollen and tender, with elevated body temperature and general malaise.
3. Abscess through the skin can form a lacrimal sac.
Examine
Acute dacryocystitis examination
1. Peripheral blood routine:
The total number of white blood cells is generally not high or decreased, and lymphocytes are increased. Severe cases can also be elevated. If combined with bacterial infection, the total number of white blood cells and neutrophils rise.
2. Blood biochemical examination:
In some cases, hypokalemia occurred, and in a few cases, creatine kinase, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, and creatinine increased.
3. Pathogen related examinations:
It mainly includes virus isolation, viral antigen, nucleic acid and antibody detection. Virus isolation is the gold standard for laboratory testing; viral antigen and nucleic acid detection can be used for early diagnosis; antibody testing can be used for retrospective investigation, but it does not make much sense for early diagnosis of cases.
4. Imaging examination:
Some patients may present with signs of bronchial infection with increased bronchial texture. In severe cases, pulmonary invasive lesions or pleural effusion may occur, or even fused into a piece.
Diagnosis
Diagnosis and differentiation of acute dacryocystitis
diagnosis
1, often have a history of chronic dacryocystitis.
2, the lacrimal sac is highly red, swollen, hot, painful, severe in the same side of the nose and redness, swelling of the ear and submandibular lymph nodes, tenderness, with elevated body temperature, general malaise.
3, abscess through the skin, can form a lacrimal sac.
Differential diagnosis
It should be distinguished from sputum abscess, sputum cellulitis, stye, and vascular edema in the lacrimal sac. The lacrimal sac flushing can be unobstructed, and other diseases have their main characteristics, so the general diagnosis is not difficult.
