Polymicrobial bacterial sepsis and defective neutrophil chemotaxis in an infant with cystic fibrosis.

A 4 1/2-month-old, white girl was admitted to the hospital with respiratory distress and persistent polymicrobial bacteremia. Cystic fibrosis associated with malnutrition and a transient defect in peripheral neutrophil chemotaxis was diagnosed. This remarkable combination of presenting features in a patient with cystic fibrosis is the focus of this case report.

Multiple hepatic tumors and peliosis hepatis in Fanconi's anemia treated with androgens.

We report the case of a 13-year-old boy who was known to have Fanconi's anemia for five years. For treatment of this condition he was given androgens and corticosteroids. Two months before his death, severe varicella developed complicated by pneumonia, jaundice, and prolonged fever; all of which resolved during a five-week hospitalization. Three weeks later he died of Clostridium septicum sepsis caused by necrotizing enterocolitis. At autopsy he was found to have multiple hepatocellular neoplasms. A striking feature of the neoplasms was cholestasis. The liver also showed peliosis hepatis. The association of the use of certain androgenic steroids with hepatic neoplasms histologically resembling hepatocarcinomas, but characterized by lack of metastases and apparent reversibility, suggests the desirability of a new nomenclature for these hepatocellular lesions.

Neonatal listeriosis.

Five cases of neonatal listeriosis were diagnosed and treated in a 13-month period. Maternal fever and "greenish discoloration" or meconium staining of amniotic fluid complicated all deliveries. Amniotic membranes were intact until artificial rupture shortly before delivery. One infant, with the "granulomatous" form of the disease, died. Four infants required mechanical ventilation. Two survivors with pneumonia, who required mechanical ventilation and 100% inspired oxygen for persistent hypoxemia, responded to tolazoline hydrochloride therapy. Early institution of antibiotics and aggressive ventilatory and pharmacological support were considered to be important factors in survival.