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Chalazion
60%
33/55
Dacryocystitis
20%
11/55
Hordeolum
0%
0/55
Orbital cellulitis
11%
6/55
Periorbital cellulitis
5%
3/55
Select Answer to see Preferred Response
This patient is presenting with inflammation and tenderness around the nasal aspect of her lower lid and medial canthus suggesting a diagnosis of dacryocystitis. Dacrocystitits is an infection of the lacrimal gland caused most commonly by Staphylococcus aureus as well as Streptococcus pneumoniae, Haemophilus influenzae, and Streptococcus pyogenes. Treatment is indicated to prevent the spread to the cavernous sinus resulting in thrombosis or meningitis. Treatment involves clindamycin, decongestants, warm compresses, and IV antibiotics if the patient is ill or symptoms are worsening. Figure A demonstrates inflammation and erythema around the patient's lower lid and medial canthus suggesting a diagnosis of dacryocystitis. Incorrect Answers: Answer 1: Chalazion presents with eyelid swelling and erythema that progresses to a painelss/rubbery nodular lesion. Answer 3: Hordeolum or a stye presents with a tender, swollen eyelid and occurs secondary to blockage and infection of a sebaceous/sweat gland. Answer 4: Orbital cellulitis presents with a swollen eye, a fever, a leukocytosis, and pain with extraocular movements. Answer 5: Periorbital cellulitis presents with swelling and erythema surrounding the eye without pain with extraocular movements. Bullet Summary: Dacryocystitis presents with tender inflammation over the medial canthus.
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