Co-occurrence of pneumococcal keratitis and dacryocystitis

Purpose. To evaluate the specific risk factors responsible for the developm ent of pneumococcal keratitis. Methods. In a ret respective analysis of 383 patients of culture-proven bacterial keratitis. seen between 1991 and 1995 , 139 had monobacterial isolates on culture. We analyzed the various predis posing factors in these patients, with special emphasis on the patency of n asolacrimal drainage system. Results. Of the 139 patients with monobacteria l keratitis, 48 (group 1) grew Streptococcus pneumoniae in culture. In the remaining 91 patients (group 2), Pseudomonas (18), coagulase-negative Staph ylococci (15), Staphylococcus epidermidis (23), Staphylococcus aureus (16), Corynebacterium species (12), and others (seven) were isolated. Trauma was found to be a predisposing factor in 12 patients of group 1 and 27 patient s of group 2 (p = 0.5601). Twelve (25%) patients of group 1 revealed chroni c dacryocystitis, and nine of them underwent sac excision. On the contrary: only three patients of group 2 demonstrated dacryocystitis (p = 0.0003). C onclusion. These results underscore the importance of assessing the patency of lacrimal drainage system in patients with infectious keratitis, especia lly of pneumococcal origin.