Multi-resistant Hafnia alvei dacryocystitis: Case report and review of literature

A 30-year-old female with no significant past medical or ocular history presented to a tertiary emergency department with left acute dacryocystitis and preseptal cellulitis that was refractory to topical and oral antibiotic therapy commenced in the community. Lacrimal sac aspiration identified presence of Hafnia alvei . She was successfully treated with dual intravenous antibiotic therapy and without systemic steroids, and an endonasal dacryocystorhinostomy was performed following the acute infection. No disease recurrence occurred during follow-up. This unusual case of H. alvei dacryocystitis and preseptal cellulitis highlights an ever-increasing bacterial spectrum and a need to consider previously unreported pathogens as causative organisms of acute dacryocystitis.