Q3 Urgent Caring- Urgent Care Q&A

Can allergic conjunctivitis cause ulcerations?

Most seasonal allergic conjunctivitis will respond optimally to a combination of antihistamine and mast cell stabilizer drops. Patients with severe allergic conjunctivitis may develop a corneal ulceration in the superior aspect of the cornea due to hypertrophic papillae. 

Source: EBM

Does penicillin allergy sensitivity decrease over time?

Many patients who report penicillin allergies do not have true IgE-mediated reactions. When evaluated, fewer than 1% of the population are truly allergic to penicillins. Approximately 80% of patients with IgE-mediated penicillin allergy lose their sensitivity after 10 years. Correctly identifying those who are not truly penicillin-allergic can decrease unnecessary use of broad-spectrum antibiotics. 

Source: CDC

What is the best method to obtain urine samples in infants?

If a clinician decides that a febrile infant with no apparent source for the fever requires antimicrobial therapy to be administered because of ill appearance or another pressing reason, the clinician should ensure that a urine specimen is obtained for both culture and urinalysis before an antimicrobial is administered; the specimen needs to be obtained through catheterization or suprapubic aspiration (SPA), because the diagnosis of UTI cannot be established reliably through culture of urine collected in a bag.

A clean-catch urinary sample is acceptable in toilet-trained children or if obtained via spontaneous voiding methods. American Academy of Pediatrics (AAP) guidelines recommend obtaining a catheterized specimen in children <6 months of age. Provocative methods have been described for obtaining a clean catch urine sample in infants. A urinary bag specimen is only helpful if negative. Culture is frequently difficult to interpret with a positive bagged specimen because most positives are false positives. Infants/children not able to spontaneously void (or with a bagged specimen with a positive UA) should have a catheterized (or suprapubic tap) specimen obtained. 

Source: AAP

Email your clinical questions to the Editors:
Tracey Davidoff, MD, FCUCM 
or Cesar Mora Jaramillo, MD, FAAFP, FCUCM at cucm@urgentcareassociation.org

Disclaimer: This material is for educational purposes only. Medical practice and knowledge are constantly evolving and changing.

This information is peer-reviewed but should not be your only source. Providers of care should use discretion when applying knowledge to any individual patient.