Epstein–Barr virus-related dacryocystitis: a case report

Article Article scientifique Rapport de cas Epstein–Barr virus-related dacryocystitis: a case report eng 2022-11-19 2022-11-19 author Sternberg Julie 722245 author Lambiel Silvia 544183 author Cao Van Hélène 804268 author Massa Horace 0000-0001-5025-3856 755189 Département des neurosciences cliniques (OTONO) author Landis Basile Nicolas 133537 Département des neurosciences cliniques (OTONO) 430 10.1186/s13256-022-03646-7 36401292 1752-1947 PMC9675078 https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-022-03646-7 Background and objective: Acute dacryocystitis is an atypical and rare manifestation of pediatric mononucleosis still widely underdiagnosed in clinical practice. We report this rare condition and describe challenges in its diagnosis and treatment on the basis of a presented case. Case presentation: A 6-year-old Caucasian girl without any ophthalmic history was admitted for right preseptal cellulitis requiring intravenous antibiotic therapy. During hospitalization, she developed a fluctuating lump in the nasolacrimal region which resembled an abscess, both clinically and radiologically. There was no spontaneous purulent discharge. Serology was positive for acute mononucleosis and Epstein–Barr virus-related dacryocystitis was diagnosed. Following multidisciplinary discussion, she was treated conservatively with digital lacrimal sac massages and intravenous antibiotic therapy with an excellent outcome. Discussion: This rare form of Epstein–Barr virus is poorly documented in the literature, and thus barely known. As initial symptoms are nonspecific (rhinitis, fever, eyelid edema and erythema lack of purulent discharge, and moderate bilateral cervical lymphadenopathy), diagnosis is often difficult. Nevertheless, differentiating between dacryocystitis and abscess is crucial to select the appropriate treatment and avoid unnecessary, potentially harmful surgery. Conservative management of dacryocystitis appears to be the gold standard of treatment. Conclusion: Acute dacryocystitis in children free of ophthalmic history should raise suspicion of primary Epstein–Barr virus infection. With conservative treatment, prognosis appears to be excellent; therefore, surgery should be avoided as much as possible. Case report Dacryocystitis Epstein–Barr virus Pediatrics Abscess / complications Anti-Bacterial Agents / therapeutic use Child Dacryocystitis / diagnosis Dacryocystitis / etiology Dacryocystitis / surgery Epstein-Barr Virus Infections / complications Epstein-Barr Virus Infections / diagnosis Female Herpesvirus 4, Human Humans Dewey 616.8 Dewey 618 61 Département des neurosciences cliniques 226 58 Département de pédiatrie, gynécologie et obstétrique 223 false 582 Ophtalmologie expérimentale 925 948 Groupe Pascal Senn 954 Journal of medical case reports 16 1 60bc1989-ec84-4410-813a-09bf77370fa5 Article (Published version) Public Article-scientifique-from-unpaywall.pdf 993454 application/pdf CC BY-4.0 91ad89d2b0711217845d95115458501bc236b2107679f5510da5234c30b36a2a openAccess Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique

Title	Published in	Year	Views	Downloads

Epstein–Barr virus-related dacryocystitis: a case report	Journal of medical case reports	2022	202	746
Récidives d'hypoglycémies en néonatologie chez les enfants nés à terme, traités par perfusion de glucose		2020	502	1,503

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Sternberg, Julie