An Infant with Bloody Tears in the Pediatric Emergency Department: Evaluation and Treatment—A Case Report and Review of the Literature

Abstract

Crying is a common complaint in infants. However, crying with bloody tears or hemolacria is an unusual finding in a pediatric emergency department. There are not many conditions that can present with bloody tears. Subconjunctival hemorrhage and hematomas are known to occur with acute Epstein Barr viral infections, accidental trauma, factor deficiencies, tumors such as malignant melanoma, Rendu-Osler-Weber disease, and idiopathic thrombocytopenic purpura. There are also unknown causes. We report an infant with immune thrombocytopenic purpura presented to the pediatric emergency department with bloody tears, who responded well to intravenous gamma globulin therapy. The presence of bloody tears should be carefully investigated as it may represent significant systemic illness, especially with a strong family history of this autoimmune condition.