RESUMEN
INTRODUCTION: Unconjugated hyperbilirubinemia is part of the everyday life of the neonatal period as it reflects the adaptation of the metabolism of bilirubin. The neonatal hyperbilirubinemia usually resolves spontaneously, but it can also be the cause of an acute or chronic encephalopathy known as kernicterus. Regardless of the cause, the goal of therapy is to prevent this neurotoxicity while not causing undue harm. Phototherapy and, if it is unsuccessful, exchange transfusion (ECT) remain the primary treatment modalities used to keep the maximal total serum bilirubin (TSB) below pathologic levels. MATERIALS AND METHODS: This is a descriptive retrospective cohort study of 69 live neonates hospitalized in the Department of Neonatology and Neonatal Resuscitation of Mohammed VI University Hospital with unconjugated hyperbilirubinemia requiring ECT and treated with intensive phototherapy instead, spanning five years from March 2016 to March 2021. We aim to demonstrate the effectiveness of phototherapy in achieving prolonged reduction of bilirubin levels and the prevention of neurological complications and to compare our results with those in the literature. RESULTS: The use of intensive phototherapy in the treatment of neonatal unconjugated hyperbilirubinemia is very effective in lowering total serum bilirubin when its level is in the range of exchange transfusion, and it has succeeded in preventing the neurological complications of severe hyperbilirubinemia. CONCLUSION: Through this study, it can be seen that phototherapy is an efficacious, simpler, and less hazardous alternative to exchange transfusion in achieving a sustained reduction of bilirubin levels and preventing neurological complications.
RESUMEN
Salmonella meningitis is a rare but severe form of bacterial meningitis. It is most frequently diagnosed in infants under one year of age, especially those under the age of three months, from emerging and underdeveloped countries and with a tropical climate. Salmonella meningitis has been associated with a high mortality rate, as well as a high risk of relapse and significant neurological complications such as cerebral palsy, visual and hearing impairments, and mental retardation. The treatment for Salmonella meningitis is challenging, and there is no consensus on the best approach. In this report, we describe a case of Salmonella meningitis in a 37-day-old girl exclusively formula-fed baby girl who was admitted for high fever, irritability, poor feeding, low activity, excessive crying for five days, and repeated seizures on the day of admission. The infant was treated with a four-week course of intravenous antibiotics. Given the severity of this infection and its potential long-term consequences, early diagnosis, and prompt treatment are crucial. However, this patient recovered without neurological disorders.
