Cases with uncharacteristic bacteria in canaliculitis

Canaliculitis is not considered to be a common condition and can be frequently misdiagnosed. The condition can also be challenging to eradicate. Canaliculitis accounts for 2-4% of lacrimal disease and is most often associated with Actinomyces israelii, Staphylococcus, and Strepococcus. However, these cases represent occasions of canaliculitis caused by uncharacteristic bacteria. We herein report three unique cases of canaliculitis that each required probing and irrigation of the infected lacrimal duct to culture bacteria following resistance to initial antibacterial treatment. Each case resulted in a different microbe, the cultures of the expelled purulent material grew Eikenella corrodens, Parvimonas micra, andCorynebacterium jeikeium respectively. All three cases occurred in rural west Texas woman with ages of 68, 70, and 40 years-old respectively. These cases highlight the importance of recognizing the possible involvement of uncharacteristic bacteria for the proper management of canaliculitis and proceeding to appropriate lacrimal procedures when empiric therapy is ineffective.