Pregnancy Complicated by Listeria Monocytogenes: A Case Report and Review of the Literature.

Listeria Monocytogenes, a small facultative anaerobic, gram positive, motile bacillus is a rare, but consequential etiologic agent of food borne illness which inordinately impacts immunocompromised individuals. The organism infects many types of animals and contaminates a multitude of foodstuffs such as milk, chicken, beef and vegetables. This microbe additionally has a distinct proclivity to infect the maternal-fetoplacental unit with resultant adverse perinatal outcomes inclusive of spontaneous abortion, preterm delivery, chorioamnionitis, neonatal meningitis and death. We present a case of Listeriosis complicating pregnancy with a subsequent comprehensive review of the literature.

Hepatitis B awareness and knowledge in hepatitis B surface antigen-positive parturient immigrant women from West Africa in the Bronx, New York.

An increasing proportion of foreign-born residents in the Bronx, New York are African immigrants from West Africa, a region with a very high hepatitis B surface antigen (HBsAg) prevalence. Charts of 114 HBsAg positive parturients who gave birth between 2004 and 2008 in a community hospital in the Bronx were retrospectively reviewed. Most were of West-African origin (88%). Acute hepatic inflammation was rare (4%). Active viral replication (Hepatitis B e-antigen positivity) was noted in a minority (7%), but in 3/5 (60%) HIV co-infected women. Among the West-African immigrant women who agreed to be interviewed (n = 39), only half (54%) had ever heard of hepatitis B virus (HBV) infection, and their knowledge of HBV was mostly incomplete. This study shows that pregnancy-related health interventions may offer unique opportunities to link such women to specialist care and initiate culturally sensitive HBV-relevant education for the index case and her family.

Lower whole blood ionized magnesium concentrations in hypocalcemic infants of gestational diabetic mothers.

Infants of insulin dependent (class B and above) diabetic mothers (IDM's) have a high rate of neonatal hypocalcemia (NHC) and hypomagnesemia. We carried out this study to test the hypotheses that: (1) infants of gestational diabetic (class A) mothers (IGDM's) are also at risk for NHC and (2) NHC in IGDM's relates to decreased whole blood Mg(2+) concentration. Thirty one term infants born to gestational diabetic mothers of classes A1 (diet controlled, n = 23) and A2 (requiring insulin, n = 8) of White's classification, were compared at 24 +/- 2 hours of age to 32 healthy, appropriate for gestational age controls, born after uncomplicated pregnancy, labor and delivery. Whole blood Mg(2+) and Ca(2+) were measured using an ion-specific electrode (Nova 8, Nova biomedical, Waltham, MA). The rate of NHC was higher in the IGDM group as compared to the control group (9 out of 31 [29%] vs. 1 out of 32 [3.1%] infants; p < 0.01). Whole blood Mg(2+) was lower in the IGDM group than in controls (p < 0.05). In multiple regression analysis, when Ca(2+) was used as the dependent variable and Mg(2+), diabetes class, gestational age, macrosomia and one minute Apgar scores were the independent variables, only Mg(2+) and diabetes class were significant (R2 = 0.4374; p < 0.01). Our results are consistent with the theory that Mg deficiency plays a role in NHC encountered in IGDM's, similar to what occurs in infants of insulin-dependent diabetic mothers.

Caudal regression syndrome versus sirenomelia: a case report.

We describe a newborn with clinical features of sirenomelia including fused lower limbs with medial position, absence of fibula, anal atresia, bilateral renal agenesis, and a single large umbilical artery. Recent literature describing the etiology of sirenomelia and relationship to caudal regression syndrome is reviewed.

Subacute sclerosing panencephalitis in Jamaica

The clinical features, outcome, electroencephalographic (EEG) and laboratory findings in 12 children with subacute sclerosing panencephalitis are described. The diagnosis was made on the clinical features, the characteristic EEG pattern and the detection of measles complement-fization antibodies in the spinal fluid and serum. The autopsy findings in 2 of 6 patients who died were typical of subacute sclerosing panenecephalitis. This report suggests that the incidence of the condition is high in Jamaica. It is recommended that strenuous efforts be made to improve the measles immunisation status of children and that a registry for the disease be established in the island (AU)

Clinical presentation of homozygous sickle cell disease

The pattern of initial clinical symptoms and signs developing in a representative sample of 305 children with homozygous sickle cell (SS) disease diagnosed at birth was analyzed. Specific symptoms were present by age 6 months in 6 percent of the group, and had developed by the first to eighth birthdays in 32 percent, 61 percent, 78 percent, 86 percent, 90 percent, 92 percent, 94 percent and 96 percent, respectively. Inclusion of nonspeccific symptoms in the analyst led to earlier recognition by a mean of 3 months in the first year and by a mean of approximately 1 year between the ages of 2 and 4 years. Dactylitis was the most common initial symptom, noted in 40 percent of the group overall and in 50 percent in the first 2 years. Painful crisis was the first symptom in more than one fourth of the patients and was the most frequent symptom after the age of 2 years. Acute splenic sequestration led to presentation in one-fifth of the group overall and in one third of the patients younger than 2 years. The most common nonspecific symptom was pneumonia. There was a significant trend of earlier presentation in children with low fetal hemoglobin levels. The age of presentation did not appear to be affected by O-thalassemia status. (AU)