%0 Journal Article
%T A Para-Canalicular Abscess Resembling an Inflamed Chalazion
%A Diamantis Almaliotis
%A Elias Nakos
%A Thomas Siempis
%A Triantafyllia Koletsa
%A Ioannis Kostopoulos
%A Maria Chatzipantazi
%A Vasileios Karampatakis
%J Case Reports in Ophthalmological Medicine
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/618367
%X Background. Lacrimal infections by Actinomyces are rare and commonly misdiagnosed for long periods of time. They account for 2% of all lacrimal diseases. Case Report. We report a case of a 70-year-old female patient suffering from a para-canalicular abscess in the medial canthus of the left eye, beside the lower punctum lacrimale, resembling a chalazion. Purulence exited from the punctum lacrimale due to inflammation of the inferior canaliculus (canaliculitis). When pressure was applied to the mass, a second exit of purulence was also observed under the palpebral conjunctiva below the lacrimal caruncle. A surgical excision was performed followed by administration of local antibiotic therapy. The histopathological examination of the extracted mass revealed the existence of actinomycosis. Conclusion. Persistent or recurrent infections and lumps of the eyelids should be thoroughly investigated. Actinomyces as a causative agent should be considered. Differential diagnosis is broad and should include canaliculitis, chalazion, and multiple types of neoplasias. For this reason, in nonconclusive cases, a histopathological examination should be performed. 1. Introduction The word actinomycosis means ¡°ray fungus.¡± £¿£¿These organisms may resemble fungi because of their filamentous semblance. Actinomycetes are a group of anaerobic, Gram-positive bacteria that vary phylogenetically, but are morphologically alike. The genus Actinomyces consists of a group of 42 species and 2 subspecies. The most common agent, concerning human diseases, among the Actinomyces species is A. israelii. However, there are less frequent species such as A. naeslundii, A. odontolyticus, A. viscosus, A. meyeri, and A. gerencseriae. Recently, new species were identified such as A. europaeus, A. neuii, A. radingae, A. graveenitzii, A. turicensis, A. cardiffensis, A. houstonesis, A. hongkongensis, and A. funkei. An infection due to Actinomyces may be related to damage of the normal physical barriers, such as the mucosal membranes in the mouth or the gastrointestinal tract. These infections can result in abscess formation and/or chronic progression [1]. Actinomyces may cause thoracic, abdominal, pelvic, central nervous system, musculoskeletal, or soft tissue infections. Ocular infections by Actinomyces are uncommon. We present a rare case of an actinomycosis beside the lower punctum lacrimale, resembling a recurrent chalazion. 2. Case Report A 70-year-old woman was referred to our clinic because of a tender, red, and painful swelling accompanied by purulent secretions in the left medial canthus,
%U http://www.hindawi.com/journals/criopm/2013/618367/