1/3. Pediatric eye injury due to Avena fatua (wild oats).OBJECTIVE: We report on florid and unusual ophthalmic physical signs in three children where the trauma was caused by seeds from Avena fatua, a grass common in western north america. DESIGN: Case series and literature review. SETTING: Three local emergency departments (ED) during the fall of 1998. patients OR PARTICIPANTS: Three children reporting to an ED with an acutely painful eye from which the foreign body was identified botanically as Avena fatua. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Symptoms, interventions, duration of problem. RESULTS: Three male children (6, 10, 14 years) presented separately following incidents in which they had sustained direct eye injury. Each child immediately experienced severe pain and profuse watering of the eye. Severe localized edema of the conjunctiva and inflammation was evident with conjunctival vessel injection leading to bleeding, reminiscent of a chemical "burn." Initially, two children appeared to have an eyelash caught behind the lower lid. In both instances, the emergency physicians initially dismissed the possibility of there being a significant foreign body, but because of the severity of the pain, conjunctival vessel injection, and edema, they attempted to remove the "lash." Removal of the foreign body proved difficult in all three cases, requiring far greater traction than anticipated. Intact seedpods had become embedded in the subconjunctival space. Ophthalmic analgesia relieved the pain immediately, but in one child who was treated with topical antibiotic alone, significant pain was experienced for 18 hours, until steroid-antibiotic therapy was instituted. All injuries occurred in late summer when the grass propagates. CONCLUSIONS: The physical signs of scleral vasculitis and conjunctival edema can be mistaken for chemical injury or allergic chemosis, but where a foreign body resembling a hair or eyelash is visible, the presence of a seed-pod retained in the subconjunctival space must be considered, particularly if the patient reports exposure to wild grass. Application of local analgesia, foreign body removal, and steroid-antibiotic treatment is recommended.- - - - - - - - - - ranking = 1keywords = grass (Clic here for more details about this article) |
2/3. Osseous foreign body reaction in the hand.We report a patient who sustained a puncture wound of the palm and developed an osteolytic metacarpal lesion probably due to an organic foreign body reaction caused by grass and wood.- - - - - - - - - - ranking = 0.33333333333333keywords = grass (Clic here for more details about this article) |
3/3. bronchiectasis resulting from aspirated grass inflorescences.bronchiectasis due to aspiration of grass inflorescences is described in three children. One patient spontaneously expelled a grass head by coughing and was not operated on. The grass inflorescence was found in the right lobe's medial segment bronchi in the second case and in the pleural cavity of the third. Pulmonary resection was performed in both cases. The clinical manifestations were of both "lodging" and "extrusive" types of aspirated grass inflorescence. This possibility must be considered in the differential diagnosis of chronic pulmonary infections in children.- - - - - - - - - - ranking = 2.6666666666667keywords = grass (Clic here for more details about this article) |