Bilateral lacrimal gland abscesses

Summary 

Dacryoadenitis is an unusual orbital infection that rarely involves acute suppuration. We describe what to our knowledge is the first reported case of bilateral lacrimal gland abscesses: a 9-year-old girl who presented with painful periorbital swelling and fever. The child was diagnosed with the abscesses by CT scan of the orbits with contrast, which was obtained when the patient's periorbital swelling progressed despite intravenous antibiotics. Despite early drainage of the abscesses, the patient sustained a complicated hospital course with epidural and cerebral abscesses. The causes of dacryoadenitis as well as the mechanisms of infectious spread into the orbit are reviewed. This case as well as a review of the literature suggest that superolaterally located orbital abscesses are associated with an increased risk of intracranial infection and should be managed aggressively.

Keywords: Dacryoadenitis, Lacrimal gland, Orbital, Periorbital, Sinusitis, Epidural abscess