11/1160. Sequential peripartum herpes simplex virus type 2 disease in parents and their newborn mimicking intrafamily spread of common viruses. herpes simplex type 2 (HSV2) disease developed sequentially among two parents and their newborn. The father first became ill with upper-respiratory symptoms and fever. Then, 5 days later, shortly after delivery, the mother had fever, pharyngitis, and diarrhea. Subsequently, the infant developed undifferentiated febrile illness at the age of 3 days. HSV etiology was recognized by incidental isolation of HSV2 from the newborn naospharynx. The father never developed genital lesions and the mother's symptoms remained nonspecific for several days prior to the onset of genital manifestations. The sequential emergence and manifestations of these infections could have been misconstrued for an intrafamily spread of respiratory or enteric viruses. This cluster illustrates that HSV2 may cause sequential symptomatic disease in susceptible individuals mimicking other viruses. ( info) |
12/1160. Congenital retarded myelinization in a new-born child with infantile spasms. A new-born child with frequent infantile spasms was investigated. In a cachectic state it died at the age of 11 months. biopsy of the cerebral cortex revealed a retarded myelinization; at autopsy this slight myelinization was found again. The ganglioside pattern suggested a developmental stage of approximately 3 months before birth. This is a case with a congenital failure of myelinization. ( info) |
13/1160. fertility and its complications in a patient with salt losing congenital adrenal hyperplasia. A report is made concerning fertility and its complications in a patient with salt losing congenital adrenal hyperplasia. fertility with a successful outcome of pregnancy has rarely been reported in women with salt losing congenital adrenal hyperplasia. Problems which have been identified in the past include non-compliance, poor endocrine follow up, secondary polycystic ovarian disease with menstrual irregularity, anovulation and problems related to sexual function. There has been only one report in the literature of a woman with salt losing congenital adrenal hyperplasia who has had two pregnancies with live births. There has been no previous report of subsequent problems with neonatal management of these children. This case highlights some of the long term hazards of management of salt losing congenital adrenal hyperplasia and reports for the first time neonatal complications possibly consequent upon prenatal maternal therapy. ( info) |
| The accurate prenatal diagnosis of anterior abdominal wall defects is important because it affects patient management and prognosis. The pathophysiology of each defect leads to key characteristics that make it possible to differentiate one entity from another. Among these features are the location of the defect in relation to cord insertion, the size and contents of the defect, and the associated anomalies. This article reviews the underlying defects, the characteristic ultrasound findings, the associated anomalies, and the prognosis of simple and complicated abdominal wall defects. The basic features of simple abdominal wall defects (i.e., omphalocele and gastroschisis) were used as the initial points of assessment. A comparison of the different features of these abnormalities and how they differ from one another resulted in the development of criteria that facilitated the understanding of the different ultrasound manifestations of these anomalies. ( info) |
15/1160. Epidemic listeriosis. Report of 14 cases detected in 9 months. During the period August 1977 to April 1978, 14 Black patients in Johannesburg area had systemic infections caused by listeria monocytogenes. Nine of these patients were neonates who presented with septicaemia (5 cases) or septicaemia and meningitis (4 cases) and 5 were adults, all of whom had meningitis. The mortality rate was 43% (6/14), with 4 neonatal and 2 adult deaths. All isolates of L. monocytogenes were type 4b. Only sporadic cases of human listeriosis have previously been reported in south africa, and the cases reported here constitute the first epidemic in this country. ( info) |
| BACKGROUND/PURPOSE: Neonates with enterostomies commonly suffer from a functional short bowel syndrome (SBS) and have a greater risk of electrolyte and fluid loss with poor weight gain. The authors describe their experience with refeeding stoma effluent into the mucous fistula in neonates. methods: A 5-year (1993 to 1997) chart review of neonates with stoma effluent refeeding was undertaken. Demographics, medical history, surgical procedures, timing, and duration of refeedings were reviewed. Enteral and total parenteral nutritional (TPN) requirements, electrolyte, and acid-base disturbances were recorded. RESULTS: Six neonates (gestational ages of 27 to 38 weeks, birth weights of 533 to 3400 g) were identified with nutritional or electrolyte complications before the commencement of refeeding. enterostomy indications included necrotizing enterocolitis (n = 2), intestinal atresia type 3b (n = 1), complications from ruptured omphalocoele (n = 1), congenital adhesive band obstruction (n = 1), and midgut volvulus after congenital diaphragmatic hernia repair (n = 1). weight gain during refeeding ranged from 5 to 25 g/kg/d with duration of refeeding lasting 16 to 169 days (two neonates were refed at home) until reanastomoses were done 6 to 44 weeks after the original surgery. There were no complications, and TPN requirements were diminished or eliminated. CONCLUSION: This technique represents a simple and safe method, which lessens the need for TPN and electrolyte supplementation in neonates with enterostomies and SBS before reanastomosis. ( info) |
17/1160. Alloimmune neonatal neutropenia treated with rHuG-CSF. Infants with alloimmune neonatal neutropenia (ANN) may be at risk of life-threatening infection. Various modalities of treatment have been attempted but with differing results. We describe a case treated with rHuG-CSF. The use of rHuG-CSF should be considered in children with ANN especially when associated with life-threatening infection. ( info) |
18/1160. hypercalcemia of the newborn: etiology, evaluation, and management. hypercalcemia in infants is uncommon but has potentially serious sequelae. This review examines four cases of neonatal hypercalcemia, emphasizing appropriate investigations and treatment of acute and chronic hypercalcemia. The paper provides additional information as to the mechanisms of calcium dysregulation in idiopathic infantile hypercalcemia, williams syndrome, vitamin d intoxication, and parathyroid and parathyroid-related protein disturbances. ( info) |
19/1160. Suicidal paracetamol poisoning of a pregnant woman just before a delivery. The aim of the paper is to present a case of self-poisoning with paracetamol, overdosed just before a delivery. A 21-year-old woman was admitted to Obstetric and gynecology Ward of local hospital in the second stage of physiological delivery, more than 6 hours after she had ingested 19 g of acetaminophen for self-poisoning. She delivered a normal infant weighing 3520 g who had Apgar scores of 10, and then both infant and mother were sent in an emergency ambulance to the nearest poison centre. blood samples for toxicological examination were taken on admission to toxicological intensive care unit i.e. 11 hours post maternal ingestion. acetaminophen levels of both patients were above the acetaminophen overdose nomogram line and the antidote treatment, i.v. N-acetylcysteine was administered according to the protocol: the mother within 11 hours post-ingestion and approximately 4 hours after a delivery; the neonate within 11 hours post maternal ingestion and 4 hours of life. Higher paracetamol concentration in the blood of infant compared to the mother's was noted in the first and then control toxicological examination performed within 35 hours post maternal ingestion. Peak maternal aspartate aminotransferase (AST) activity was 326 U/L within 35 hours and alanine aminotransferase (ALT) activity was 262 U/L within 56 hours post-ingestion. The highest neonatal enzyme activity was noted within 11 hours post maternal ingestion of paracetamol, and the elevation was not high. Except moderate anaemia in the mother, no clinical or biochemical symptoms of renal, cardiovascular or CNS injury were stated in the mother or infant. Normalisation in the maternal enzymes activity was stated within 226 hours, while in the neonatal within 58 hours post maternal ingestion. The woman recovered without sequelae and was discharged from hospital on the 11th day following paracetamol overdosing. No evidence of the liver injury was found in the infant either. ( info) |
20/1160. Optic disc edema in neonatal onset multisystem inflammatory disease (NOMID). PURPOSE: To inform ophthalmologists about neonatal onset multisystem inflammatory disease (NOMID), a rare condition with ophthalmologic manifestations. methods: We report a single case of NOMID with optic disc edema. RESULTS: A 28-month-old child with neonatal rash, arthropathy, central nervous system (CNS) involvement, and optic disc edema was diagnosed with NOMID. CONCLUSIONS: The finding of posterior uveitis or optic disc edema in a child with juvenile onset arthritis may allow the differentiation of NOMID from juvenile rheumatoid arthritis. ( info) |