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Maria Fernandez-Ruiz, Jonathan Go, Amit Bhatt; Characteristic radiologic findings in pediatric patients with adenoviral epidemic keratoconjunctivitis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5213.
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To describe characteristic radiologic findings in pediatric patients with adenoviral epidemic keratoconjunctivitis.
A descriptive retrospective case series of pediatric patients with adenoviral epidemic keratoconjunctivitis who were admitted to the pediatric Texas Children’s Hospital service. 7 cases of patients diagnosed with presumptive preseptal cellulitis and admitted for IV antibiotics were included. All patients were imaged before consultation by the pediatric ophthalmology service. After eye examination, diagnosis of adenoviral epidemic keratoconjunctivitis (EKC) was made. We reviewed orbital CT imaging and identified specific and consistent radiological findings seen in all seven cases.
7 cases were reviewed, which included patients ages 0-18 years (mean: 2.75 years) admitted to the hospital, treated with IV antibiotics and imaged with orbital CT with and without contrast, all due to presumed bacterial preseptal cellulitis. On imaging, all patients were noted to have thickening and enhancement of the conjunctival surface. Imaging also revealed a characteristic triangular appearance between the conjunctiva and lateral wall of the orbit. Clinical examination then confirmed a diagnosis of EKC, allowing discontinuation of antibiotics and more rapid discharge from the hospital. The disease process resolved in all 7 patient with supportive therapy.
Adenoviral epidemic keratoconjunctivitis may demonstrate characteristic radiologic findings on contrast CT, the identification of which may obviate the need for hospital admission and long courses of broad-spectrum systemic antibiotics. These radiologic findings are not usually seen in other infectious processes, especially bacterial preseptal cellulitis.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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