Korean J Ophthalmol.  2013 Aug;27(4):288-290. 10.3341/kjo.2013.27.4.288.

Caruncular Abscess Due to Actinomycosis

• Lee YH
• Kim WJ
• Lee SB

• KMID: 1705426
• DOI: http://doi.org/10.3341/kjo.2013.27.4.288

Abstract

The authors report a caruncular abscess caused by actinomycosis. A 47-year-old woman was admitted with persistent purulent discharge from the caruncle of the left eye for a duration of six months. Excisional drainage was performed, and 'sulfur granules' were observed, consistent with actinomyces infection. Intraoperative lacrimal probing and irrigation were performed to confirm that the abscess and canaliculus were not connected. Oral and topical antibiotics were administered postoperatively; the lesion resolved with no evidence of recurrence, and the symptom improved.

Keyword

Abscess; Actinomycosis; Caruncle; Lacrimal apparatus

MeSH Terms

Abscess/drug therapy/*microbiology
Actinomycosis/*diagnosis/drug therapy
Anti-Bacterial Agents/therapeutic use
Female
Humans
Lacrimal Apparatus Diseases/drug therapy/*microbiology
Middle Aged
Anti-Bacterial Agents

Figure

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  Fig. 1 The slit lamp photograph shows swelling and erythema in the left pericaruncular area, with purulent drainage.

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  Fig. 2 (A) Orbital computed tomography. Peripheral enhancing low-density lesion, approximately 1 cm in diameter, in the left lower eyelid area, suggestive of an abscess. (B) T2-weighted magnetic resonance imaging shows a high signal intensity lesion of the same size in the medial portion of the left lower eyelid area, consistent with an abscess.

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  Fig. 3 (A) Intraoperative microscopic photograph shows 'sulfur granules' in the caruncular cyst. (B) Histopathologically, actinomycotic sulfur granules are identified. The bulk of the granule is composed of amorphous material with neutrophils clinging to the edge (hematoxylin-eosin, ×100).

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