1/31. Liposomal amphotericin b in neonates with invasive candidiasis.Liposomal amphotericin b (L-Amp B), a novel formulation of amphotericin b, is effective for the treatment of invasive fungal infections in children and adults and is associated with less toxicity than the conventional preparation. Data on the use of Liposomal amphotericin b in neonates is scarce. We describe the clinical course of two premature infants who were treated with Liposomal amphotericin b (one infant had candidemia, and the other had candidemia and meningitis), and provide a summary of previously published experience on this topic. Liposomal amphotericin b may be an option for therapy of invasive candidiasis in neonates who are at high risk of nephrotoxicity and other amphotericin-related reactions, but clinical trials are necessary to document its safety and efficacy in this age group.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
2/31. Successful treatment of late-onset infection due to resistant klebsiella pneumoniae in an extremely low birth weight infant using ciprofloxacin.OBJECTIVE: This paper presents a case in which an extremely low birth weight infant with multidrug-resistant klebsiella pneumoniae infection was successfully treated with ciprofloxacin and gentamicin. STUDY DESIGN: A clinical case report of a neonate who received broad spectrum antibiotics for possible infection despite negative cultures. The infant developed sepsis and meningitis resulting from multidrug-resistant K. pneumoniae, which was treated with ciprofloxacin and gentamicin. The literature for the use of ciprofloxacin in pediatric patients was reviewed. RESULTS: The infant responded to the antibiotic regimen with sterilization of blood and cerebrospinal fluid; no adverse effects were attributable to the ciprofloxacin. Although ciprofloxacin has been found to cause irreversible injury to cartilage in juvenile laboratory animals, a review of the literature found that this complication occurs rarely if at all in pediatric patients. ciprofloxacin has been found to be effective in the treatment of multidrug-resistant Gram-negative infections in pediatric patients, including premature infants. CONCLUSION: ciprofloxacin should be considered in the treatment of neonatal infection caused by multidrug-resistant Gram-negative organisms. Although the published experience with this drug suggests that it is effective and that significant toxicity is not common, its use should be restricted to the treatment of serious infections for which an alternative antibiotics is not available.- - - - - - - - - - ranking = 1keywords = meningitis (Clic here for more details about this article) |
3/31. Neonatal group B streptococcal disease associated with infected breast milk.Premature triplets each developed late onset group B streptococcal disease over a period of nine weeks. The source of the organism appeared to be expressed maternal breast milk, in the absence of clinical mastitis. Asymptomatic excretion of group B streptococcus in breast milk may be an under-recognised cause of neonatal infection.- - - - - - - - - - ranking = 0.45622882133389keywords = streptococcus (Clic here for more details about this article) |
4/31. Delayed presentation of congenital diaphragmatic hernia in association with group B streptococcus infection in a preterm Omani neonate.We present an interesting case of a preterm Omani newborn that had delayed onset of congenital diaphragmatic hernia in association with group B streptococcus infection. The association and the pathogenesis are supported by literature review. The message to follow is that any neonate with prolonged course of streptococcal pneumonia, with unusual course, should be investigated for presence of congenital diaphragmatic hernia.- - - - - - - - - - ranking = 2.2811441066694keywords = streptococcus (Clic here for more details about this article) |
5/31. streptococcus bovis infection in young Infants.BACKGROUND: Sporadic cases of invasive streptococcus bovis disease have been reported in young infants. However, little is known about the clinical manifestations or the conditions that predispose to S. bovis infection in this population. OBJECTIVE: The objective of this case series and review of the literature was to describe cases of S. bovis infection treated at 2 children's hospitals and compare patients evaluated at our institutions with those reported in the literature. RESULTS: Seven infants with S. bovis infection were treated at our institutions; 4 of the patients had S. bovis meningitis and 3 of these also had S. bovis bacteremia. Five of the patients had signs of gastrointestinal disturbance at presentation. None of the 7 patients died. Twenty-three patients with S. bovis infection reported in the literature had meningitis with concurrent bacteremia (n = 9), bacteremia alone (n = 9), meningitis alone (n = 4), and pneumonia with overwhelming sepsis (n = 1). Six (26%) of the patients reported in the literature died as a consequence of S. bovis infection. The difference in median age between our patients (14 days; range, 1-43 days) and those reported in the literature (3 days; range, 1-60 days) was not statistically significant (P = 0.49). Abdominal distention was more commonly noted among patients in our series (71%) than among patients reported in the literature (10%; odds ratio = 21.3; 95% confidence interval = 1.7-319.0). CONCLUSIONS: bacteremia and meningitis were the most common manifestations. Gastrointestinal disturbance was common among patients in our series. The mortality rate from S. bovis infection appears to be lower than suggested by previous reports.- - - - - - - - - - ranking = 4keywords = meningitis (Clic here for more details about this article) |
6/31. neutropenia in an extremely premature infant treated with recombinant human granulocyte colony-stimulating factor.neutropenia in the newborn is often associated with sepsis, maternal hypertension, or prematurity. We describe a 654-g infant born at 30 weeks' gestation by cesarean section due to severe maternal hypertension. His course was complicated by five episodes of sepsis, including three with group B streptococcus. The results of hematologic and immunologic studies were normal except that absolute neutrophil counts were low (less than 1 x 10(9)/L) with intermittent increases during sepsis. Human recombinant granulocyte colony-stimulating factor administered subcutaneously (10 micrograms/kg per day initially) resulted in an absolute neutrophil count of greater than 30 x 10(9)/L within 2 weeks. The dosage was lowered and the absolute neutrophil counts were maintained at 8 to 12 x 10(9)/L with no further septic episodes. The human recombinant granulocyte colony-stimulating factor therapy was discontinued after 7 months, and the patient remained healthy with an absolute neutrophil count of greater than 2 x 10(9)/L. Thus, treatment with human recombinant granulocyte colony-stimulating factor may be useful as a temporary measure for neonatal neutropenia associated with sepsis. A controlled, clinical trial is warranted.- - - - - - - - - - ranking = 0.45622882133389keywords = streptococcus (Clic here for more details about this article) |
7/31. Neonatal meningitis and bilateral cerebellar abscesses due to citrobacter freundii.We report bilateral cerebellar abscesses in a neonate with citrobacter freundii meningitis. The mortality and morbidity of Citrobacter abscess is high. Rapidly developing drug resistance may play a role as illustrated by our case.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
8/31. Fatal Streptococcus viridans septicemia and meningitis: relationship to fetal scalp electrode monitoring.viridans streptococci have been reported as an increasingly frequent pathogen in neonatal sepsis. These infections have appeared to be less virulent than those associated with other bacteria. The case of an infant is reported who developed a scalp abscess secondary to an internal fetal monitoring electrode caused by viridans streptococci. This infection evolved into a rapidly fatal septicemia and meningitis. viridans streptococci may be responsible for virulent fatal infections in neonates.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
9/31. Unexpected diagnosis of candida albicans meningitis in a premature neonate.candida albicans meningitis was found in an otherwise healthy 44-day-old premature infant whose birth weight was 1,860 gm. Almost no abnormal clinical or neurologic findings were present. The electroencephalogram, however, was abnormal. All previous body fluid cultures were negative. The combined use of amphotericin b and 5-fluorocytosine resulted in negative cerebrospinal fluid cultures after 3 weeks of therapy. Physical and psychomotor development remained normal on subsequent examination.- - - - - - - - - - ranking = 5keywords = meningitis (Clic here for more details about this article) |
10/31. candida albicans meningitis in a premature neonate successfully treated with 5-fluorocytosine and amphotericin b: a case report and review of the literature.candida albicans meningitis was diagnosed in a 45-day-old premature infant whose birth weight was 1,616 gm. Symptoms consisted of poor weight gain and poor suckling. The combined use of amphotericin b and 5-fluorocytosine (5-FC) resulted in negative CSF cultures after 12 days of therapy. amphotericin b was given for 45 days (total 83 mg) and 5-FC for 60 days (total 19 mg). Only one other premature infant has been reported in the literature who had similar treatment. A review of Candida meningitis diagnosed before death in 11 other infants less than 1 year of age is presented.- - - - - - - - - - ranking = 6keywords = meningitis (Clic here for more details about this article) |
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