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- W2969654083 abstract "A 21-day-old infant was referred to the emergency department because of purulent discharge and sublacrimal swelling of both eyes during the past week. During the previous 3 days, the patient had received oral amoxicillin-clavulanic acid, without clinical improvement. The patient was afebrile and well appearing. Physical examination revealed bilateral mucopurulent ocular secretions and a tender red swelling under the left medial canthus (Figures 1 and 2). Pupillary reflexes and ocular movements were normal.Figure 2Left acute dacryocystitis. A localized reddish swelling under the left medial canthus and purulent secretions from the lower lacrimal punctum are shown.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Uncomplicated acute dacryocystitis. Dacryocystitis is an acute infection of the nasolacrimal sac, usually occurring in the neonatal period as a complication of a congenital nasolacrimal duct obstruction.1Ali M.J. Pediatric acute dacryocystitis.Ophthal Plast Reconstr Surg. 2015; 31: 341-347Crossref PubMed Scopus (37) Google Scholar, 2Pinar-Sueiro S. Sota M. Lerchundi T.X. et al.Dacryocystitis: systematic approach to diagnosis and therapy.Curr Infect Dis Rep. 2012; 14: 137-146Crossref Scopus (34) Google Scholar Dacryocystitis is characterized by erythema and the presence of a tender lesion proximal to the medial canthus of the eye, mucopurulent secretions from the lacrimal puncta, and concomitant conjunctivitis.1Ali M.J. Pediatric acute dacryocystitis.Ophthal Plast Reconstr Surg. 2015; 31: 341-347Crossref PubMed Scopus (37) Google Scholar, 3Hoffmann J. Lipsett S. Acute dacryocystitis.N Engl J Med. 2018; 379 (474-474)Google Scholar, 4Moore N.A. Chundury R.V. A neonate with acute dacryocystitis.JAMA Ophthalmol. 2018; 136: 86Google Scholar The infection can spread quickly, giving rise to orbital and facial cellulitis or meningitis, requiring prompt systemic antibiotic treatment.1Ali M.J. Pediatric acute dacryocystitis.Ophthal Plast Reconstr Surg. 2015; 31: 341-347Crossref PubMed Scopus (37) Google Scholar, 2Pinar-Sueiro S. Sota M. Lerchundi T.X. et al.Dacryocystitis: systematic approach to diagnosis and therapy.Curr Infect Dis Rep. 2012; 14: 137-146Crossref Scopus (34) Google Scholar Normal extrinsic ocular movements and pupillary reflexes are helpful in ruling out orbital cellulitis, and ultrasonography can be useful to exclude expansive lesions (hemangiomas, nasal glioma, encephalocele, and dermoid cysts) or intraorbital complications such as orbital cellulitis.4Moore N.A. Chundury R.V. A neonate with acute dacryocystitis.JAMA Ophthalmol. 2018; 136: 86Google Scholar, 5Vázquez-Osorio I. Hernández-Martín A. Usefulness of ultrasonography in the diagnosis of neonatal dacryocystocele.Pediatr Dermatol. 2017; 34: 209-210Crossref PubMed Scopus (2) Google Scholar In our patient, ultrasonography revealed an abscess of the lacrimal sac (Figure 3). He was treated with intravenous ceftriaxone for 5 days, with rapid improvement and complete healing in 1 week. Seven days of oral antibiotics were provided at hospital discharge. Ocular culture swab was positive for methicillin-sensitive Staphylococcus aureus. Blood culture results were negative. Follow-up evaluation of nasolacrimal duct patency was arranged." @default.
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- W2969654083 date "2019-09-01" @default.
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- W2969654083 title "Newborn With a Swelling Cherry Eye" @default.
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- W2969654083 doi "https://doi.org/10.1016/j.annemergmed.2019.02.028" @default.
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