1/92. Second-trimester abortion caused by capnocytophaga sputigena: case report.Intra-amniotic infection is often the cause of a second-trimester abortion. The bacterial species involved include bacteria with low pathogenicity like ureaplasma urealyticum and various mycoplasma species. In this case we describe an intra-amniotic infection caused by capnocytophaga sputigena, often found in the normal bacterial flora of the oral cavity, but not in the vagina. Oral sex during pregnancy was the most probable source of the infection. The aborted fetus showed signs of pneumonia upon histologic examination. The bacterial species was identified using broad-spectrum 16S rDNA polymerase chain reaction (PCR) directly from the amniotic fluid and after bacterial culture. amniotic fluid glucose was below detection level, confirming the presence of an intra-amniotic infection.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
2/92. Chlamydial ophthalmia neonatorum.A case of chlamydial ophthalmia neonatorum is presented. The importance of early diagnosis and treatment is discussed.- - - - - - - - - - ranking = 11.447673398288keywords = chlamydial (Clic here for more details about this article) |
3/92. nitric oxide in the treatment of fulminant pulmonary failure in a young pregnant woman with varicella pneumonia.extracorporeal membrane oxygenation is the recommended treatment for fulminant pulmonary failure due to varicella pneumonia. However, in pregnancy fetal viability during extracorporeal membrane oxygenation is generally poor resulting in either therapeutic or spontaneous abortion. The present case is to our knowledge the first report on the treatment with nitric oxide to improve oxygenation in a pregnant woman with fulminant pulmonary failure due to varicella pneumonia. Adding 20 parts per million nitric oxide to the inspiratory gas increased arterial oxygen saturation from 75 to 88%, and it could be kept at this level. Due to a vaginal bleeding, an emergency Caesarean section was performed with successful outcome for the fetus. The mother started to improve after delivery and could be weaned from nitric oxide after 5 days. We conclude that inhalation of nitric oxide may be a good alternative to extracorporeal membrane oxygenation in the treatment of fulminant pulmonary failure due to varicella pneumonia in pregnancy.- - - - - - - - - - ranking = 7keywords = pneumonia (Clic here for more details about this article) |
4/92. Legionnaire's disease complicating pregnancy: a case report with intrauterine fetal demise.OBJECTIVE: Legionnaire's disease complicating pregnancy is an unusual event that can seriously compromise both the mother and the fetus. CASE REPORT: We describe one case of such association, with an unfavourable intrauterine fetal outcome, secondary to acute placental insufficiency, related to infection. DISCUSSION: It is important in these high risk pregnancies complicated by acute pneumonia to take into consideration the diagnosis, as early as possible, and the appropriate treatment or the careful monitoring of fetal wellbeing.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
5/92. Congenital cytomegalovirus infection: three autopsy case reports.We report three autopsy cases of congenital cytomegalovirus (CMV) infection in fetuses with a review of literature. The clinical manifestations in these cases of congenital CMV infection include intrauterine fetal death, hydrops fetalis, and CMV pneumonia associated with cardiovascular defect. The pathological characteristics were as follows: 1) the kidney was the most frequently involved organ, followed by lung and liver, 2) CMV inclusions were found predominantly in epithelial cells and to a lesser degree in endothelial cells, 3) intrahepatic bile duct epithelial cells were frequently involved, and 4) inflammatory reaction around CMV inclusions was not prominent in the early stage of pregnancy. Diagnostic confirmation was obtained by in situ hybridization (ISH) using a biotinylated CMV-dna probe, which demonstrated intranuclear inclusions and sometimes recognized cells that did not show intranuclear inclusion.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
6/92. Congenital skin lesions caused by intrauterine infection with coxsackievirus B3.BACKGROUND: Serious neonatal coxsackievirus infections transplacentally acquired in late pregnancy involve primarily the central nervous system, heart, liver and rarely the skin. patients AND methods: A boy born with a disseminated papulovesicular, nodular, bullous and necrotic ulcerated rash at 39 weeks gestational age developed pneumonia, carditis and hepatitis during the first days after birth. Molecular biological and serological methods were used for virological diagnosis. RESULTS: Coxsackievirus B3 (CVB3) was found in throat swabs and/or feces of the neonate and his mother. In addition, there was serological evidence of intrauterine infection. CONCLUSION: Intrauterine transmission of CVB3 during late pregnancy may lead to varicella-like congenital skin lesions.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
7/92. Reversal of intra-amniotic chlamydia trachomatis antigen status.chlamydia trachomatis (CT) infection in pregnant women is related to unfavorable obstetric outcomes such as prematurity, intrauterine growth retardation, and stillbirth. A 22-year-old woman underwent transabdominal amniocentesis at 16 weeks of gestation (GW). A CT antigen test using polymerase chain reaction in the amniotic fluid was found to be positive, though the patient had no symptom of infection. Beginning at 20 GW, clarithromycin was orally administered at a dose of 400 mg/day for 2 weeks. The CT antigen test in amniotic fluid at 28 GW turned to a negative result. A female baby was vaginally born at 38 GW by spontaneous labor. The CT antigen test of her gastric contents showed a negative result and anti-CT IgM in umbilical cord blood was negative. Neither respiratory distress, pneumonia, nor conjunctivitis was detected. To the best of our knowledge, this case is the first report showing the reversal of the intra-amniotic CT antigen status by antibiotic treatment.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
8/92. sepsis in second trimester of pregnancy due to an infected myoma. A case report and a review of the literature.Considering the high incidence of uterine myomata in women in reproductive age, myomata are only found in 2% of all pregnancies. Although they frequently lead to complications in pregnancy, cases of pyomyomata during pregnancy are rarely reported. A 44-year-old gravida 1 in her 26th week of gestation was admitted to the hospital for septic temperatures of unknown cause. A 12-cm leiomyoma with solid structures of heterogenic sonographic pattern and cystic spaces had been documented on a prior first trimester sonogram. The myoma now appeared with the same size but an increased echogenicity of the liquid parts. Ultrasound guided aspiration of the fluid within the myoma showed an infection with klebsiella pneumoniae. A cesarian section with myo- mectomy confirmed the diagnosis of a pyomyoma.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
9/92. pneumocystis carinii pneumonia in pregnancy.OBJECTIVE: To report five new cases of pneumocystis carinii pneumonia (PCP) and to review and analyze the existing reports on the subject. METHOD: Five new cases of PCP during pregnancy are described. The cases, case series, and related articles on the subject in the English language were identified through a comprehensive medline search and reviewed. RESULTS: More than 80% of women with AIDS are of reproductive age, and PCP is the most common cause of AIDS-related death in pregnant women in the united states. Among 22 reviewed cases, the mortality rate was 50% (11 of 22 patients), which is higher than that usually reported for hiv-infected individuals with PCP. Respiratory failure developed in 13 patients (59%), and mechanical ventilation was therefore required, and the survival rate in patients requiring mechanical ventilation was 31%. Maternal and fetal outcomes were better in cases of PCP during the third trimester of the pregnancy. A variety of treatment regimens were used, including sulfamethoxazole-trimethoprim (SXT) alone or in combination with pentamidine, steroids, and eflornithine. The survival rate in patients treated with SXT alone was 71% (5 of 7 patients) and for those treated with SXT and steroids was 60% (3 of 5 patients), with an overall survival rate in both groups of 66.6% (8 of 12 patients). CONCLUSION: PCP has a more aggressive course during pregnancy, with increased morbidity and mortality. Maternal and fetal outcomes remain dismal. Treatment with SXT, compared to other therapies, may result in an improved outcome. Withholding appropriate PCP prophylaxis may adversely affect maternal and fetal outcomes.- - - - - - - - - - ranking = 5keywords = pneumonia (Clic here for more details about this article) |
10/92. Toxic shock-like syndrome with flu-like prodrome: a possible role of 'enhancing tissue focus' for streptococcal toxic shock.We describe three patients with invasive group A streptococcal infection, admitted during the 3 months between November 1996 and February 1997. All patients were previously healthy Japanese women who developed a profound shock, with a rapidly fatal outcome, after experiencing flu-like symptoms. All cases conformed to the case definition of toxic shock-like syndrome (TSLS).Currently, the pathogenic mechanism of TSLS remains unclear. Known microbial virulence factors can not sufficiently explain the occurrence of TSLS, and it has been generally considered that host factors may be contributory. On pathological examination, each patient had one organ or tissue that was most severely involved: Case 1 a non-penetrating trauma; Case 2 a pregnant uterus; and Case 3 a pulmonary lesion reminiscent of lymphocytic interstitial pneumonia. On the basis of clinicopathological features of these cases, we propose that the coexistence of 'enhancing tissue focus' may be one of host factors for the progression of TSLS in patients infected with non-invasive GAS.- - - - - - - - - - ranking = 1keywords = pneumonia (Clic here for more details about this article) |
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