J Korean Ophthalmol Soc.  2011 Nov;52(11):1357-1361.

Idiopathic Orbital Inflammation Presenting as Unilateral Dacryoadenitis in a Child

• Yum HR
• Kang NY

Abstract

PURPOSE
To report a case of idiopathic orbital inflammation presenting as unilateral acute dacryoadenitis in a child.
CASE SUMMARY
A nine-year-old boy presented with painful swelling and redness in the right upper eyelid and temporal conjunctiva without systemic symptoms for five days. Acute orbital cellulitis was suspected but did not respond to systemic antibiotics. An orbital computed tomogram and magnetic resonance imaging revealed a diffusely enlarged and inflamed right lacrimal gland. The patient showed dramatic response to systemic corticosteroids, and acute dacryoadenitis due to idiopathic orbital inflammation was diagnosed. Treatment with oral corticosteroids for two months resolved the inflammation. No relapse was observed during four months of follow-up.
CONCLUSIONS
Although rare, acute dacryoadenitis as a localized nonspecific orbital inflammation should be considered in the differential diagnosis of acute orbital cellulitis in pediatric patients.

Keyword

Acute dacryoadenitis; Eyelid swelling; Idiopathic orbital inflammation; Orbital cellulitis

MeSH Terms

Adrenal Cortex Hormones
Anti-Bacterial Agents
Child
Conjunctiva
Dacryocystitis
Diagnosis, Differential
Eyelids
Humans
Inflammation
Lacrimal Apparatus
Magnetic Resonance Imaging
Orbit
Orbital Cellulitis
Recurrence
Adrenal Cortex Hormones
Anti-Bacterial Agents

Figure

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  Figure 1. (A) Erythematous swelling and mechanical ptosis of the right upper eyelid. (B) Inflammatory enlargement of the palpebral lobe of right lacrimal gland with yellowish nodular lesion and mild chemosis and injection of the temporal conjunctiva. (C) Markedly enlarged and inflammed palpebral lobe in the upper fornix. (D) Two months after treatment, inflammatory enlargement of the lacrimal gland and injection of the conjunctiva was subsided.

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  Figure 2. Orbital computed tomogram without enhancement. (A) Axial view showed right lacrimal gland enlargement and preseptal soft tissue swelling. There was no erosion of adjacent bones. (B) Coronal view shows enlargement of the right lacrimal gland and periorbital soft tissue swelling.

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  Figure 3. T2-weighted orbital MRI findings. (A) Axial shows nonenhancing diffusely enlarged right lacrimal gland with enhancing ovallesions and swelling of the right temporal eyelid. (B) Two months after treatment, complete resolution of the previous dacryoadenitis in the right lacrimal gland.

Reference

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