[Neonatal endocarditis: report of a case]. / Endocardite neonatale: descrizione di un caso.

Neonatal endocarditis (NE) is a rare and usually fatal disease. The diagnosis is difficult because the criteria that have been suggested and used in adults are not readily applicable to neonates. The cause of the neonatal endocarditis can be bacterial (BE) or nobacterial (NBE). The main risk factors predisposing to NE are: congenital heart disease, the use of central venous catheters and severe asphixia. The signs and the symptoms of NE are nonspecific and cannot be distinguished from those of sepsis or congenital heart disease (CHD). In the present paper we report on a case sheltered in our neonatal intensive care unit (NICU).

[Hydrops fetalis correlated with voluminous chorioangioma of the placenta]. / Idrope fetale correlata ad un voluminoso corionangioma della placenta.

Hidrops is a term used to describe generalized subcutaneous edema in the fetus or neonate. It is usually accompanied by ascites and often by pleural or pericardial effusion (or both). The etiology is varied. Chorionangioma, one of the most frequent placental tumors, is often associated with an important hidrops fetails. In the present paper we propose an our case.

[Retropharyngeal abscess in nursing infants. Report of 2 cases]. / Ascesso retrofaringeo nel lattante. A proposito di 2 osservazioni.

The authors report two cases of retropharyngeal abscess in breast-fed babies and highlight the salient points of the disease: 1) The disease is rare, severe and sometime atypical. 2) The clinical features are: the patient age (breast-fed babies), difficult in swallowing, drooling, dyspnea and malaise. 3) The diagnosis is confirmed by a forward movement of the pharynx and of the soft palate except when the abscess is located on the lower half of the retropharyngeal space. 4) The most important diagnostic procedure is the lateral radiography of the neck that shows a widening of the retropharyngeal prevertebral space. 5) If an adequate therapy is not undertaken, following complications are possible: opening of the abscess with passage of the pus into the bronchopulmonary space, obstructive dyspnea with oxygen lack, propagation of the abscess into the mediastinum and possible development of fistulas into lung, and pleura, and exceptionally into pericardium. 6) The therapy includes the use of drugs active toward the possible etiological agents: the most common are the S.B.E.A., anaerobes, staphylococcus and gram-negative. At stage of suppuration, surgical operation is required.

[Perinatal listeriosis. Apropos of two cases]. / Listeriosi perinatale. A proposito di due casi.

Two cases of perinatal listeriosis are reported by the Authors. The Authors emphasize that in Italy the incidence of this disease is undervalued. Additionally, the pregnant woman comes to be affected by forms which do not clinically fall within standard levels and whose course does not get worse over a certain limit. On the other hand, the fetus suffers substantial damages like abortion, premature labour with its subsequent failure or in case with a fetus affected by listeriosis. Two main clinical forms do exist in the neonatal period: the early form that is the septicemic form and the later form that is the meningitic form. As regards therapy on newborn, the Authors report that a mixture of Ampicillin and Aminoglycosides turns out to be successful for recovering patients from listeriosis. Furthermore, the Ampicillin together with a general igienic therapy are a good protection for the fetus and newborn in a pregnant woman.

[Therapy of neonatal infection caused by group B beta-hemolytic Streptococcus]. / La terapia dell'infezione neonatale da streptococco beta-emolitico di gruppo B.

Expectant therapy for early Group B Streptococcus onset septicemia must provide coverage against other microorganism, such as L. Monocytogenes, H. Influenzae and S. Pneumoniae. It is possible to administer a combination of antimicrobial agents with activity against all or the most likely pathogens. Thus initial expectant therapy includes a broad spectrum semisynthetic penicillin (e.g. ampicillin) and an aminoglycoside (e.g. netilmicin). Vancomicin, teicoplanin and cefotaxime may also be used. Supportive therapy consists on temperature control, i.v. administration of fluids, acid-base balance and electrolytes monitoring, seizures control and ventilation. IV immunoglobulins, granulocyte and serum transfusion are also used. The G-Colony Stimulating Factor (G-CSF, filgastrim) usage is also reported.

[Cardiac rhabdomyoma in a newborn infant with tuberous sclerosis. Value of 2-dimensional and Doppler echocardiography]. / Rabdomioma cardiaco in neonato con sclerosi tuberosa. Ruolo dell'ecocardiografia bidimensionale e Doppler.

Cardiac rhabdomyomas are the most frequent primary cardiac tumors in infancy and childhood and in about 50% of cases are associated with tuberous sclerosis. They are often responsible for a high mortality rate because of their critical location and extent of involvement. This report describes a patient with tuberous sclerosis and multiple cardiac rhabdomyomas, both intramyocardial and intracavitary--diagnosed by two dimensional and Doppler echocardiography at birth. The infant was followed till nine months of age. To date, the tumors have not increased their size and don't provoke moderate or severe obstruction of blood flow. The child is, at present, free from cardiac signs and symptoms, and does not take digitalis or diuretics. We have not detected any arrhythmias. Two-dimensional and Doppler echocardiography are very useful non-invasive techniques in the diagnosis and longitudinal follow-up of patients with cardiac rhabdomyomas.