Abstract

Background and objective: Pediatric mononucleosis manifests atypically and rarely in acute dacryocystitis, which is still clinically underdiagnosed. On the basis of a case that is described, we highlight the difficulties in diagnosing and treating this uncommon ailment.
Present a case: A 6-year-old Caucasian girl was admitted for intravenous antibiotic therapy for right preseptal cellulitis without any prior ocular history. She developed a fluctuating lump in the nasolacrimal area while in the hospital, and both clinically and radiographically, it looked like an abscess. There was no unprovoked release of pus. Acute mononucleosis was confirmed by serology, and dacryocystitis caused by the Epstein-Barr virus was identified. She received conservative treatment with digital lacrimal sac massages and intravenous antibiotic medication after
multidisciplinary discussion, and the results were outstanding.
Discussion: Since there is little information about this uncommon Epstein-Barr virus strain in the literature, it is little known. The non-specific nature of the first symptoms (rhinitis, fever, erythema and edoema of the eyelids without purulent discharge, and mild bilateral cervical lymphadenopathy) makes identification challenging. However,distinguishing between a dacryocystitis and an abscess is essential to choosing the right course of action and avoiding unneeded, potentially hazardous surgery. The best course of treatment for dacryocystitis appears to be conservative care.
Conclusion: Acute dacryocystitis in kids without a history of eye problems should raise the possibility of a primary Epstein-Barr virus infection. The prognosis appears to be excellent with conservative therapy; consequently, surgery should be avoided whenever possible.