Abstract
BACKGROUND: Acute dacryoadenitis is characterized by inflammation of the lacrimal gland, and is typically viral. Bacterial dacryoadenitis is rare, with Staphylococcus and Streptococcus species being the most common pathogens. The bilateral sequential onset of dacryoadenitis has not been described in the literature to date. CASE PRESENTATION: A 54-year-old immunocompetent female presented to the emergency department with a 1-week history of left-sided periorbital swelling, erythema, and pain. Orbital computed tomography demonstrated significant soft tissue thickening and swelling surrounding the left orbit and a lacrimal gland abscess. Culture swabs were negative for microorganisms. Despite initial management with intravenous antibiotics and surgical drainage, the condition recurred post-discharge. Three years later, the patient experienced similar symptoms in the right eye. Cultures were repeatedly negative for microorganisms. Despite courses of intravenous antibiotics and surgical drainage, the patient experienced recurrences of abscesses in the right eye, highlighting the challenges in managing this rare condition. CONCLUSIONS: We describe a unique case of bilateral sequential bacterial dacryoadenitis with abscess formation. This case highlights the need for prompt diagnosis and management, including surgical intervention, to prevent complications and recurrences.