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A 6-week-old infant presented to accident and emergency with apnoeic episodes. On arrival, the infant was pale and floppy, requiring fluid resuscitation and intubation prior to transfer to the paediatric intensive care unit. Broad spectrum intravenous antibiotics were commenced and the infant made a good recovery, being extubated after 48 h. Lumbar puncture was unsuccessful; however, blood cultures were positive for Streptococcus pneumoniae.
By day 4, the infant's left eye was noted to be closed over and ophthalmological assessment revealed a complete ptosis (figure 1). The pupil was dilated and unreactive to light. The resting position of the left eye was downward and outward with limited ocular movements in the superior and medial directions.
Which cranial nerve is affected?
What causes of this condition should be …
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