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.
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.
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.
Email your clinical questions to the Editors:
Tracey Davidoff, MD, FCUCM
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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.