Dacryoadenitis

Question 1

What is it?

Answer 1

Acute or chronic inflammation of the lacrimal gland

Question 2

Etiology

Answer 2

Idiopathic
bacterial- staph, strep, Syphilis, gonorrhoeae
Viral- Mumps, mono, flu, zoster
Autoimmune, inflammatory systemic disease

Question 3

Laterality based on etiology

Answer 3

Idiopathic, systemic disease = bilateral
Bacterial = unilateral
Viral can be both

Question 4

Symtpoms

Answer 4

Temporal upper eyelid swelling, more localized to lacrimal gland.
Redness and tenderness/pain
Droopy eyelid 
Tearing
Fever if infectious 
Discharge if bacterial 
Dry eye if chronic

Question 5

Signs

Answer 5

S shape eyelid
Lacrimal gland palpable
Globe displaced inferior and medial
Inflam may extend into conj - conj injection and chemises

Bacterial- discharge
Viral- swollen preauricular lymph nodes

Question 6

Complications

Answer 6

Orbital cellulitis

Question 7

Management

Answer 7

To rule out cellulitis, orbital CT scan or MRI
Tx with oral antibiotics. If no response, consider different etiology.

Could tx with anti viral or steroid if inflammatory/non infectious.

Question 8

What is more common? Infectious or non infectious

Answer 8

Non infectious. Typically chronic with mild signs and symptoms.
Sarcoid is the most common non-infectious etiology.

Question 9

What is common with infectious etiologies?

Answer 9

Typically acute with more severe signs and symptoms
viral is most common
Bacterial is rare

Question 10

What is the most common cause of an infectious etiology?

Answer 10

Viral