Acute dacryocystitis in a paediatric patient under 18 years of age demands a coordinated, age-specific management strategy. The approach is guided by the child's age and accounts for the serious systemic risks that accompany this presentation in younger patients.
This protocol targets children under 18 years presenting with acute dacryocystitis. Management is coordinated with paediatric specialists and includes systemic as well as local treatment, with the choice of lacrimal intervention determined by the patient's specific age within this group.
The protocol centres on hospital admission for close observation and blood cultures, with intravenous antibiotic therapy forming the initial systemic cornerstone — the full drug selection, dosing, local ophthalmic regimen, and age-stratified lacrimal procedure sequence are specified in the complete structured regimen.
Intubation of the nasolacrimal duct, hospital admission and the use of intravenous antibiotics have been recommended.
In pediatric patients, we recommend admission to hospital for observation, in coordination with pediatricians, performing blood cultures and early use of a lacrimal probe in patients under the age of two, or dilation, intubation or dacryocystorhinostomy in older children.
These procedures should be preceded by at least 24 h of intravenous antibiotic therapy, given the relatively high risks of sepsis, meningitis and endocarditis.
DOI: 10.1007/s11908-012-0238-8
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