Caruncular Abscess Due to Actinomycosis
A 47-year-old woman was a dmitted to o ur clinic for persistent purulent discharge from the left eye for a duration of six months. She had been diagnosed with chronic conjunctivitis at a private eye clinic. Despite conservative treatment, the symptom was persistent, leading to referral of this patient to our clinic. Her corrected visual acuity was 1.2, and no specific findings were noted in her past medical history. Slit lamp examination showed discharge via a fistula in the central part of the caruncle of the left eye, a red and swollen caruncle, and mild hyperemic conjunctiva (). Lacrimal drainage was patent to syringing and showed no reflux in the upper or lower canaliculus of the left eye. Computed tomography (CT) scan and magnetic resonance imaging (MRI) showed an elliptical hypo-dense lesion of about 1 cm in diameter in the medial portion of the left lower eyelid (). Caruncular abscess was diagnosed preoperatively, and excisional drainage and bacterial culture were performed. Intraoperative lacrimal probing and irrigation were performed to confirm that the abscess and canaliculus were not connected. Bacteria were not identified in the culture, but biopsy of the lesion confirmed a benign purulent cyst with 'sulfur granules' by histopathologic examination (). Postoperative oral and topical antibiotics were administered; the lesion resolved with no evidence of recurrence within four months, and the symptom significantly improved.