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Dacryoadenitis Caused by Blastomycosis: A Case Report

Dacryoadenitis Caused by Blastomycosis: A Case Report This is the first case of histopathologically proven blastomycosis involving the lacrimal gland. A 51-year-old woman with a history of disseminated blastomycosis involving her lungs and skin, on oral itraconazole, presented with 3 days of right upper eyelid swelling, erythema, and pain concerning for recurrent dacryoadenitis. MRI showed enlargement of the right lacrimal gland with a cystic lesion at the anterior aspect of the gland with a radiographic differential diagnosis of abscess versus cyst. After no improvement with intravenous antibiotics, orbitotomy with lacrimal gland biopsy and incision and drainage of the cystic lesion were performed. Culture and pathology of the drained fluid demonstrated an abscess with both viable and nonviable broad-based budding yeast consistent with partially treated blastomycosis. The patient’s symptoms improved after the surgery and continued itraconazole therapy. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Ophthalmic Plastic & Reconstructive Surgery Wolters Kluwer Health

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Publisher
Wolters Kluwer Health
Copyright
© 2019 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.
ISSN
0740-9303
eISSN
1537-2677
DOI
10.1097/IOP.0000000000001445
Publisher site
See Article on Publisher Site

Abstract

This is the first case of histopathologically proven blastomycosis involving the lacrimal gland. A 51-year-old woman with a history of disseminated blastomycosis involving her lungs and skin, on oral itraconazole, presented with 3 days of right upper eyelid swelling, erythema, and pain concerning for recurrent dacryoadenitis. MRI showed enlargement of the right lacrimal gland with a cystic lesion at the anterior aspect of the gland with a radiographic differential diagnosis of abscess versus cyst. After no improvement with intravenous antibiotics, orbitotomy with lacrimal gland biopsy and incision and drainage of the cystic lesion were performed. Culture and pathology of the drained fluid demonstrated an abscess with both viable and nonviable broad-based budding yeast consistent with partially treated blastomycosis. The patient’s symptoms improved after the surgery and continued itraconazole therapy.

Journal

Ophthalmic Plastic & Reconstructive SurgeryWolters Kluwer Health

Published: Sep 1, 2019

References