The relationship between scoring systems and cytokine levels in neonatal sepsis.

In this study, 20 newborn infants with sepsis were evaluated and scored according to the criteria of Töllner and Rodwell and associates. Leukocyte count, serum C-reactive protein (CRP), tumour necrosis factor (TNF)-alpha and interluekin (IL)-6 levels were also studied in all infants. The aim of this study was to determine if a relationship exists between the scoring systems and the cytokine levels in neonatal sepsis. The infants were divided into two groups as blood culture positive and negative. Blood culture was positive in 12 (60%) infants. We did not find a significant difference for leukocyte count, cytokine levels and scoring systems between the blood culture positive and negative groups. However, we found a positive correlation between the scoring systems and serum CRP and TNF-alpha levels (P < 0.05), but no correlation with IL-6. In conclusion, we suggest that only serum CRP level without performing scoring and studying serum TNF-alpha concentration may be used in early diagnosis of neonatal sepsis. However, further studies are necessary to define this because of the small sample size of our pilot study.

Bilateral proptosis caused by orbital myositis. A case report.

Proptosis, unilateral or bilateral, is a frequent indication for medical evaluation and orbital computed tomography. The most common cause of proptosis in adults and children is inflammatory disorders. Orbital myositis is a subgroup of the orbital pseudotumor syndrome in which one or more of the extraocular muscles are primarily infiltrated by an inflammatory process. Computed tomography and ultrasonography showed enlargement of one or more extraocular muscles in orbital myositis. In our case, we observed clinically and by orbital computed tomography, evidence of isolated bilateral extraocular muscle swelling after upper respiratory tract infection. Proptosis and other findings were spontaneously and completely resolved after twenty days. Because proptosis caused by orbital myositis is extremely rate in children and there is limited information in the literature, this case was reported.