What is Dacryoadenitis in Children?
Dacryoadenitis in children (acute dacryoadenitis) is an inflammation of the lacrimal gland. Types: one-sided and two-sided.
Causes of Dacryoadenitis in Children
The disease is a complication of common infections such as tonsillitis, flu, typhoid fever, scarlet fever, mumps and pneumonia.
Symptoms of Dacryoadenitis in Children
Most often, unilateral acute dacryoadenitis occurs, in rare cases, the lesion is bilateral. The disease has an acute onset. The skin in the outer part of the upper eyelid turns red and swells. Because of the edema, the outer edge of the upper eyelid falls, so the palpebral fissure takes the form of the letter S. The mobility of the eyeball is limited, it shifts down and in. As a result, diplopia occurs. Diplopia is understood to mean such a visual impairment in which objects “double” in the child’s eyes.
Pulling the upper eyelid, you can see that the conjunctiva is swollen and red. If you lightly press your fingers on the outer part of the upper eyelid, the child will feel severe pain. The enlargement and soreness of the ear lymph nodes is recorded. Body temperature rises, symptoms such as headache and general malaise appear.
Diagnosis of Dacryoadenitis in Children
Diagnosis of acute dacryoadenitis in children is simple. The doctor has a fairly typical clinical picture (symptoms of the development of the disease) and anamnesis (data about the child that may be associated with the disease).
Treatment of Dacryoadenitis in Children
Children with dacryoadenitis are treated in the vast majority of cases in a hospital. First of all, UHF therapy, dry heat, UV irradiation of the affected eye are used (first 3 biodoses, and after a day they are increased by 1 biodose, reaching five to six).
For 2-3 weeks, the child needs to drip anti-inflammatory and antimicrobial drugs into the conjunctival sac. Glucocorticosteroids: Maxitrol, Betam-Ophthal. Nonsteroidal anti-inflammatory drugs: Indocollyr, Naklof.
- 0.05% picloxidin solution is instilled 3 times a day
- Miramistin 0.01% solution is also instilled 3 times a day
- a solution of sulfacyl sodium 10-20% (3 r per day)
- a solution of chloramphenicol (3 r per day)
A course of 2-3 weeks before bedtime in the conjunctival sac should be placed antimicrobial ointments, for example, erythromycin or tetracycline.
If systemic therapy is used, it includes non-steroidal anti-inflammatory (NSAIDs) and antibacterial agents from 1 week to 10 days.
Apply such NSAIDs:
- 3 times a day after meals inside of 25 mg of indomethacin
- rectally, diclofenac sodium 50-100 mg 2 times a day or intramuscularly (Ortofen, 2.5% solution for injection in ampoules of 3 ml) 60 mg 1-2 times a day.
If antibacterial agents are used to treat dacryoadenitis in children, bacteriostatic and bactericidal agents are usually combined.
Antibiotics for the treatment of dacryadenitis:
- penicillins from 5 to 14 days
- ampicillin inside
- oxacillin inside
- ampicillin intramuscularly
- oxacillin intramuscularly
- benzylpenicillin sodium salt intramuscularly
- benzylpenicillin sodium salt intravenously
- aminoglycosides intramuscularly or intravenously (gentamicin).
Cephalosporins have a bactericidal effect, they are taken vanutrially or intramuscularly in a course of 5 to 14 days. The most effective of them: cefotaxime, ceftriaxone.
Sulfanilamide preparations have a bacteriostatic effect, the course, again, from 5 days to 2 weeks. Inside take sulfadimidine, co-trimoxazole.
If the infection is anaerobic, metronidazole is administered intravenously over the course of 5-10 days (session duration from 30 to 60 minutes).
If the symptoms of intoxication are pronounced, for 1-3 days, such drugs as a hemodesis solution (200-400 ml) and a 5% glucose solution of 200-400 ml with ascorbic acid (2 grams) are administered intravenously.
For 5 to 10 days, the intravenous administration of a solution of calcium chloride 10% and a solution of 40% hexamethylenetetramine should be alternated.
If an abscess appears on the affected area, and palpation causes a fluctuation (a symptom of pus), surgical methods are used. When opening the abscess, the incision is made parallel to the arch from the conjunctiva. After opening the abscess, drainage with a 10% sodium chloride solution is necessary. In medicine, drainage is understood as a method of draining wounds and cavities from pus and other fluids (in this case, the cavity that remained after opening the abscess). For 3 to 7 days, the wound should be washed with antiseptic solutions, for example, 1% dioxin solution. A solution of furatsilina 1: 5000 and a solution of hydrogen peroxide 3% are also suitable.
As the wound of the subsequent procedures will be cleaned, for 5-7 days three to four times a day, this area should be lubricated with drugs that promote healing, for example, 5-10% methyluracil ointment or Levomikol. In parallel with the drugs listed above, magnetotherapy is used.
Evaluation of the effectiveness of treatment of dacryoadenitis in children
The duration of the disease in standard cases is 10-15 days. The course is benign, the infiltrate tends to reverse development. But there may be suppuration of the lacrimal gland and the formation of its abscess, which sometimes opens without surgical intervention through the skin of the upper eyelid, or palpebral tissue in the conjunctival cavity. The likelihood of developing chronic inflammation is not excluded.
Prevention of Dacryoadenitis in Children
To prevent such an unpleasant disease, it is necessary to timely and adequately treat sore throat, flu and other diseases described above in paragraph What causes dacryoadenitis. Children must maintain good hygiene when taking care of their eyes.