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Updated: Jul 5, 2026

Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

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Published on: October 13, 2017

Nocardia canaliculitis presenting as pouted punctum.

Salman Asghar¹, Abid Mahmood, Mehreen Ali Khan

¹Department of Ophthalmology, Combined Military Hospital, Gujranwala Cantt. dr_salman_asghar@yahoo.com

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP

|May 3, 2008

Summary

A rare case of Nocardia canaliculitis, an infection of the tear drain, was successfully treated. This chronic condition, marked by persistent eye inflammation and tearing, required surgical removal of concretions and antibiotic therapy.

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Area of Science:

Ophthalmology
Medical Microbiology

Background:

Nocardia canaliculitis is a rare bacterial infection affecting the lacrimal drainage system.
Chronic conjunctivitis and epiphora unresponsive to conventional treatments may indicate unusual pathogens.

Observation:

A patient presented with a 1.4-year history of chronic conjunctivitis and epiphora, refractory to multiple treatments.
Physical examination revealed chronic conjunctivitis and a pouted punctum in the right lower eyelid.
"Sulfur granules" were expressed during probing and sac syringing.

Findings:

Microbiological analysis confirmed the presence of Nocardia species in the expressed "Sulfur granules".
Culture-positive Nocardia canaliculitis was diagnosed.
The patient's condition was successfully managed with surgical removal of concretions and appropriate antibiotic therapy.

Implications:

This case highlights the importance of considering Nocardia in refractory chronic conjunctivitis and epiphora.
Prompt diagnosis and targeted treatment, including surgical intervention and antibiotics, are crucial for successful management.
Nocardia canaliculitis requires specific microbiological investigation and tailored therapeutic approaches.