RESUMO
The authors are reporting a case of autoimmune lymphoproliferative syndrome in a newborn who presented with massive hepatosplenomegaly, thrombocytopenia, and anemia at birth. Antenatal ultrasound revealed a fetus with hepatosplenomegaly. The infant was treated with steroids and sirolimus and is doing well at 4 years of age. This is the first case report of autoimmune lymphoproliferative syndrome presenting as hepatosplenomegaly during fetal life.
Assuntos
Síndrome Linfoproliferativa Autoimune/patologia , Hepatomegalia/patologia , Sirolimo/uso terapêutico , Esplenomegalia/patologia , Trombocitopenia/patologia , Antibióticos Antineoplásicos/uso terapêutico , Síndrome Linfoproliferativa Autoimune/complicações , Síndrome Linfoproliferativa Autoimune/tratamento farmacológico , Feminino , Hepatomegalia/complicações , Hepatomegalia/tratamento farmacológico , Humanos , Recém-Nascido , Prognóstico , Esplenomegalia/complicações , Esplenomegalia/tratamento farmacológico , Trombocitopenia/complicações , Trombocitopenia/tratamento farmacológicoRESUMO
AIM: Our aim was to identify the clinical features and outcome of multidrug resistant Candida auris (CA) infection in neonates. METHODS: This is a retrospective case cohort study of 17 neonates who developed sepsis caused by CA infection in a tertiary care neonatal intensive care unit over 3 years. The risk factors, clinical features, treatment and outcome were studied. RESULTS: The mean gestation was 32.4 ± 4.9 weeks with overall mortality of 41%. Clinical features were indistinguishable from other causes of sepsis. CA was sensitive to micafungin but resistant to fluconazole and had variable sensitivity to voriconazole and amphotericin. Survival improved to 83% when infants were treated with a combination of micafungin and amphotericin. Non-survivors were of lower birthweights and had other risk factors. CONCLUSIONS: The management guidelines and infection control measures are described in this largest series of neonatal CA infection. Treatment with a combination of amphotericin and micafungin improved the outcome.
Assuntos
Antifúngicos , Candida , Antifúngicos/uso terapêutico , Candidíase Invasiva , Estudos de Coortes , Humanos , Lactente , Recém-Nascido , Testes de Sensibilidade Microbiana , Estudos RetrospectivosRESUMO
BACKGROUND: Intractable obstructive apneas requiring multiple intubations are rare in newborns. CASE CHARACTERISTICS: We report a pair of twins born at 29 weeks gestation who had severe obstructive apneas due to Paradoxical Vocal Cord Motion (PVCM). OUTCOME: The symptoms resolved promptly with ipratropium nebulization. Follow-up at 12 months of age revealed normal development. MESSAGE: PVCM should be considered in the differential diagnosis of intractable obstructive apneas in very low birth weight preterm infants.
