Unilateral acute dacryocystitis associated with oculoglandular tularemia: a case report.

PURPOSE: To describe an unusual case of oculoglandular tularemia associated with unilateral acute dacryocystitis and purulent conjunctivitis with 18 weeks pregnancy.

METHODS: It is difficult to culture francisella tularensis on media so serological tests such as micro-agglutination methods are used to diagnose the infection. PCR test results were weak positive. The serum sample was analyzed for the presence of f. tularensis antibody, which was determined positive with a titer of 1/160.

RESULTS: Oral amoksicilin-clavulonic acid treatment was applied to the patient because of the side-effects of other antibiotics on the fetus. Dacryocystitis was surgically drained but relapsed a few weeks later, so it was drained again and a ciprofloksasin-impregnated sponge was placed into the tissue defect that occured after drainage. No relapses were seen after recovery of dacryocystitis.

CONCLUSIONS: Oculoglandular tularemia is not only suspected in cases who complain of fever, cervical lymphadenopathy and purulent conjunctivitis, it should also be suspected in cases who are admitted to the hospital with acute dacryocystitis, which is a rare component of oculoglandular syndrome.