[Neonatal liver abscess after umbilical venous catheter]. / Abcès hépatique néonatal lié à un cathéter veineux ombilical.

INTRODUCTION: The use of an umbilical venous catheter (UVC) is common practice in neonatal units and is subjected to strict rules of insertion and monitoring to detect potential complications. Hepatic abscess is one of these rare complications. OBSERVATION: We report the observation of a 15-day-old female newborn admitted for a hepatic abscess. The patient had been hospitalized at birth in a neonatal intensive care unit. With the appearance of hemodynamic instability on the 4th day of life, a nosocomial infection was suspected and was treated with ceftazidime, vancomycin and amikacin. Later, as the need for O(2) increased and plasma C-reactive protein (CRP) was 190 mg/L, the patient received imipenem and vancomycin, while an abdominal ultrasound examination showed a hepatic abscess. A triple antibiotic treatment was initiated with imipenem, vancomycin, and metronidazole, while the initial examination showed a clinically stable patient with a CRP at 208 mg/L. Abdominal ultrasounds showed a hepatic abscess measuring 53.4×24.9 mm on day 21 and 51.4 mg/L CRP. Then the abscess dimensions decreased to 35.7×14 mm. The antibiotic therapy was maintained for 4 weeks. CONCLUSION: Hepatic abscess should be suspected in neonates with UVC with sepsis and persistent signs of inflammation in spite of adequate antibiotic treatment.

[Epidemic of nosocomial infection by rotavirus in a neonatology service]. / Epidémie d'infection nosocomiale à rotavirus au sein d'un service de néonatologie.

The goal of work is to establish a clinical descriptive analysis of the epidemic of nosocomial rotavirus occurred in the Neonatal Unit of the Hospital's Child Rabat for a winter period. We systematically collected all the patients of the service right from the first case of rotavirus nosocomial infection. Patients with a stay of less than 48 hours of hospitalization were excluded. We have established operating sheets for all positive cases, with the term, birth weight, postnatal age and weight during the sampling, clinical symptoms, treatment, and the evolution. Out of the 36 cases analyzed (where 26 preterm and 10 term neonates), 12 samples were positive for rotavirus, so one third of patients. The patients with positive samples were in 75% symptomatic cases. The clinical signs were represented in term newborns with stool weight with stagnant fluid in 2 cases and weight loss in one case and in premature infants with mucous stools with abdominal distension in 2/3 of cases, and fluid and stool dehydration in 1/3 of cases. A very low rate of breastfeeding (17%) was noted among all newborns service in this epidemic. We performed the isolation of positive patients, with a strengthening of hygiene measures. In addition, infants were started on symptomatic treatment with careful clinical monitoring. Evolution was complicated by necrotizing enterocolitis in 3 cases of preterm infants.