[Maternal-fetal staphylococcal toxic shock syndrome with chorioamniotitis]. / Choc toxique staphylococcique maternofoetal sur chorioamniotite.

We report a rare case of mother-infant pair with Staphylococcal Toxic Shock Syndrome (TSS). A term neonate was born by caesarean section for maternal septic syndrome during per-partum. He presented with respiratory distress complicated by pulmonary hypertension, skin rash, and multiple organ system involvement. Staphylococcus aureus was isolated from placenta, surface swabs and gastric aspirate. He received adapted antibiotics, respiratory support by high frequency ventilation and NO. The mother had shock, skin rash and inflammatory syndrome. Outcome was good in both cases. The isolate produced enterotoxin C and L. Shock, exanthematous disease and multi-organ involvement complicating a staphylococcal infection in neonate must lead to suspect a TSS.

[Adverse effects of ketoprofen after intrauterine exposure. Value of plasma determination]. / Les effets secondaires du kétoprofène après exposition intra-utérine. Intérêt du dosage plasmatique.

BACKGROUND: Prostaglandin synthetase inhibitors have been used to prevent the onset of premature labor. But a small number of newborn infants have been reported with premature closure of the ductus arteriosus, pulmonary hypertension and/or oliguria. POPULATION AND METHODS: Eleven neonates from seven pregnancies were admitted because they suffered from adverse effects of ketoprofen given to their mothers before delivery. The plasma ketoprofen level was measured in 6 of the neonates. RESULTS: Ten of the 11 neonates had renal dysfunction which was lethal in three; two of the 11 developed cardiopulmonary complications, lethal in one. The ketoprofen concentration in plasma was high in the first few hours of life in three patients. CONCLUSION: In the absence of precise risk factors for prognosis, repeated drug measurements in the maternal plasma before delivery and in their babies after birth could be a predictive factor.

Pulmonary mechanics in ventilated preterm infants with respiratory distress syndrome after exogenous surfactant administration: a comparison between two surfactant preparations.

The effects of two surfactant preparations on lung mechanics have been studied on 24 ventilated premature infants with respiratory distress syndrome (RDS): 13 were given artificial surfactant (Exosurf Neonatal, Burroughs-Wellcome) and 11 natural porcine surfactant (Curosurf, Laboratoire Serono France). Measurements of respiratory system compliance (Cdyn, Crs) and resistance (Rrs) were performed immediately before surfactant administration and repeated 6, 18, 24, 48, and 72 hours later. With Exosurf treatment, 6 hours after surfactant administration inhaled O2 concentration (FlO2) could be lowered from (0.72 +/- 0.20, to 0.62 +/- 0.33; P < 0.05), whereas Crs did not change (0.37 mL/cmH2O/kg, +/- 0.14 vs. 0.39 +/- 0.12, NS). After 24 hours and during the following days a significant increase in Crs occurred (24 hours post-Exosurf: 0.51 +/- 0.18, P < 0.05). With Curosurf treatment, the improvement in oxygenation was greater and FlO2 could be lowered much more after 6 hours (from FlO2, 0.78 +/- 0.23 to 0.34 +/- 0.11, P < 0.01). This was associated with an increase in Crs (from 0.39 +/- 0.09 to 0.59 +/- 0.17, P < 0.05). During the following days, Crs was significantly higher in the group treated with Curosurf. Resistance was not altered by the type of surfactant preparation used except after 72 hours, when Rrs increased in the group treated with Exosurf. In conclusion, Curosurf appears to be more effective than Exosurf with regard to immediate pulmonary changes in ventilator treated premature infants with RDS. A rapid increase in Crs after Curosurf treatment indicates that recruitment of new functional areas of the lung is likely to be associated with a stabilization of small airways and alveolar units.

[Maternal-fetal transmission of genital mycoplasma infection]. / Infection materno-foetale à mycoplasmes génitaux.

The authors report on a case of a preterm infant who suffered from pneumonia due to genital mycoplasma infection. Hepatic dysfunction was associated. Tetracyclines were successful.

[Frontonasal dysplasia or the median cleft face syndrome: a case report]. / La dysplasie frontonasale ou syndrome de la fente médiane de la face. A propos d'une observation.

Frontonasal dysplasia (FND) is a condition with a more or less severe ocular hypertelorism and, sometimes, a narrowing of the palpebral fissures. The nose is broad and flattened with clefting; it may be bifid or completely divided in two halves. In extreme cases, the central nervous system is concerned and there is a mental deficiency. There is no coronal craniosynostosis in pure FND. Other malformations can be observed. Among the cases reported in the literature, most of them are sporadic but they may be familial. We report here a sporadic case of F.N.D. in which scan examination of the brain shows a possible cephalocele. The literature is briefly reviewed.