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1.
Euro Surveill ; 28(24)2023 06.
Artículo en Inglés | MEDLINE | ID: mdl-37318763

RESUMEN

Echovirus 11 (E11) has recently been associated with a series of nine neonatal cases of severe hepatitis in France. Here, we present severe hepatitis caused by E11 in a pair of twins. In one of the neonates, the clinical picture evolved to fulminant hepatitis. The E11 genome showed 99% nucleotide identity with E11 strains reported in the cases in France. Rapid genome characterisation using next generation sequencing is essential to identify new and more pathogenetic variants.


Asunto(s)
Infecciones por Echovirus , Hepatitis A , Hepatitis , Necrosis Hepática Masiva , Recién Nacido , Humanos , Masculino , Italia/epidemiología , Francia/epidemiología , Enterovirus Humano B/genética , Infecciones por Echovirus/diagnóstico , Infecciones por Echovirus/epidemiología
2.
Pediatr Dermatol ; 36(5): 702-706, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31355466

RESUMEN

Transient myeloproliferative disorder (TMD) is a spontaneously resolving clonal myeloid proliferation characterized by circulating megakaryoblasts in the peripheral blood that is restricted to neonates with Down syndrome (DS) or those with trisomy 21 mosaicism. Cutaneous manifestations of TMD are observed in only 5% of affected neonates and present as a diffuse eruption of erythematous, crusted papules, papulovesicles, and pustules, often with prominent and initial facial involvement. We describe the case of a male infant with DS and TMD, associated with a vesiculopustular eruption, which appeared on day 36 of life, and review previous cases.


Asunto(s)
Síndrome de Down/complicaciones , Reacción Leucemoide/complicaciones , Enfermedades Cutáneas Vesiculoampollosas/etiología , Síndrome de Down/patología , Humanos , Recién Nacido , Reacción Leucemoide/patología , Masculino , Enfermedades Cutáneas Vesiculoampollosas/patología
3.
Nutrients ; 13(2)2021 Feb 18.
Artículo en Inglés | MEDLINE | ID: mdl-33670693

RESUMEN

Breastfeeding is recommended for all neonates due to a known variety of beneficial effects, but infants can be infected by cell-associated bacteria and viruses from breast milk, such as cytomegalovirus (CMV). The majority of CMV-seropositive breastfeeding women have a viral, self-restricted reactivation, can shed the virus in the milk for about 12 weeks after delivery, and can transmit the infection to their offspring. Post-natal CMV-infected term infants are mainly asymptomatic, while very low birth weight (VLBW, <1500 g) and extremely low birth weight (ELBW, <1000 g) infants may present with severe disease, short-term sequelae ranging from abnormalities in laboratory indexes to sepsis-like syndrome, and long-term sequelae such as developmental problems. Thus, the use of thermally treated maternal milk for VLBW/ELBW infants may be indicated to prevent/reduce the risk of CMV transmission. Different techniques, with varying efficacy in eradicating CMV and maintaining the activity of biological compounds in milk are available: long/short pasteurization, freeze-thawing, the use of microwaves, and ultraviolet-C irradiation. In our NICU, the use of maternal raw milk is always strongly recommended for term/preterm infants, but to reduce risk of CMV transmission, freeze-thawing mother's own milk is used in neonates with GA ≤ 30 weeks or/and weight ≤ 1000 g, usually regardless of serological maternal condition, as CMV screening is not routinely offered to pregnant women and the milk of seroimmune mothers is not evaluated for CMV reactivation, as its rate is similar to seroprevalence. Over the last 4 years, we had 10 VLBW/ELBW newborns in our NICU with late-onset sepsis and negative cultures. In these cases, the research of CMV DNA in neonatal urine or saliva, for the diagnosis of post-natal symptomatic infection (once congenital transmission has been excluded) may be useful and not invasive. The take-home message we would like to share is that acquired CMV infection should be considered in VLBW/ELBW infants breastfed by seropositive mothers and presenting severe symptoms-particularly sepsis with negative cultures. This could allow pediatricians to make better-quality diagnoses, perform supportive therapy, provide antiviral treatment if needed, or establish a "pre-emptive" therapy for these high-risk neonates.


Asunto(s)
Lactancia Materna/efectos adversos , Infecciones por Citomegalovirus/epidemiología , Citomegalovirus , Recién Nacido de muy Bajo Peso , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Adulto , Infecciones por Citomegalovirus/transmisión , Femenino , Hospitales , Humanos , Recién Nacido , Italia/epidemiología , Masculino , Leche Humana/virología , Embarazo , Complicaciones Infecciosas del Embarazo/virología
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