Congenital bronchobiliary fistulas (CBBF) are rare developmental anomalies. We report a case of a 6-day-old newborn who presented with respiratory distress and bilioptysis, originally involving a meconium aspiration syndrome. The diagnosis was confirmed by bronchoscopy. Surgery was performed at the age of 26 days and the newborn died the following day. Operative opacification showed communication between the carina and the biliary system. We review the clinical characteristics of CBBF and the value of early diagnosis and surgical treatment to prevent pulmonary complications due to bile salts.
Biliary Fistula/congenital , Bronchial Fistula/congenital , Respiratory Distress Syndrome, Newborn/etiology , Bile Reflux/complications , Bile Reflux/diagnosis , Bile Reflux/surgery , Biliary Fistula/diagnosis , Biliary Fistula/surgery , Bronchial Fistula/diagnosis , Bronchial Fistula/surgery , Bronchoscopy , Diagnosis, Differential , Fatal Outcome , Female , Humans , Infant, Newborn , Meconium Aspiration Syndrome/complications , Meconium Aspiration Syndrome/diagnosis , Respiratory Distress Syndrome, Newborn/diagnosis , Tomography, X-Ray Computed
UNLABELLED: Nosocomial infections, caused by multiresistant bacteria, are very common in neonatal intensive care units (NIU) and they engage the vital prognosis. MATERIAL AND METHODS: From January 1994 to December 1995, 29 children suffered from nosocomial infections due to multiresistant bacteria. RESULTS: Bacteria were isolated in blood cultures and/or in cerebrospinal fluid and included Klebsiella (14 cases), Enterobacter (eight cases), Pseudomonas (three cases), Acinetobacter (one case), Stenotrophomonas maltophilia (one case) and Flavobacterium odorantum (one case). After preliminary antibiotic therapy, ciprofloxacin was introduced and associated with another antibiotic for 10 days. Outcome was favorable in 25 cases with sterilization of blood culture. Four deaths were due to acute respiratory failure. One case of skin rash and five cases of transient thrombocytopenia were observed during the six days of ciprofloxacin therapy. No articular complication and no dental abnormalities were observed during the 14-38-month follow-up. Ciprofloxacin appears to be a good therapeutic choice for the treatment of severe nosocomial infections in NICU. Side effects are rare, mild, and transient. However, the prevention of nosocomial infection remains essential.
Anti-Infective Agents/therapeutic use , Ciprofloxacin/therapeutic use , Cross Infection/drug therapy , Drug Resistance, Multiple , Intensive Care Units, Neonatal , Anti-Infective Agents/pharmacology , Bacterial Infections/drug therapy , Child, Preschool , Ciprofloxacin/pharmacology , Female , Humans , Infant , Infant, Newborn , Male , Treatment Outcome
