After the deaths of 2 preterm neonates with Bacillus cereus systemic infection in the same intensive care unit, we investigated the pathogenic potential of this bacterium. Genetic and virulence analysis indicated the neonates were infected with 2 different strains with a virulence potential similar to environmental strains, indicating likely patient immune response failure.

The intrathecal infusion of Baclofen seems to be an effective treatment in patients with supraspinal spasticity.

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Congenital FVII deficiency or hypoconvertinemia is a rare and heterogeneous disorder with prevalence of around one individual per 500 000 [1]. It is an autosomal recessive disease. This deficiency is asymptomatic in 50% of homozygous and in most heterozygous patients. Severe bleeding manifestations tend to occur mainly in homozygous or compound heterozygous individual. FVII gene is located in chromosome 13. To date, molecular analysis allowed the characterization of more than 200 different mutations. However, the correlation between residual FVII coagulation activity and bleeding tendency or severity of manifestations seems to be poor [2]. Therefore, the clinical presentation is quiet variable and independent of FVII plasma levels [1,3]. A FVII deficiency is suspected when clotting screening tests reveal isolated prolonged prothrombin time with normal APTT value and confirmed using specific FVII:C assays [2].Spontaneous cord haematoma (SCH) is uncommon, but a severe life-threatening gestational accident. It represents a rare cause of acute foetal distress that may be shown by the decrease of foetal movement or foetal death [4]. Many risk factors have been reported: short cord, twisting and traction of the cord, post-maturity, infection, morphologic abnormality and alterations of the vascular wall. Meanwhile, rupture of the umbilical vein has been reported as the main cause of cord haematoma by many authors [4].We describe the case of a patient born from a normal pregnancy who presented with an SCH discovered at delivery, secondary to composite heterozygous congenital factor VII deficiency. To our knowledge, this is the first case ever reported in the literature.A female infant was born full-term from non-consanguineous parents after a caesarean section because of mother's complaint of decreased foetal movement and foetal heart decelerations. At birth, the baby was 'flat' (Apgar score of 0 at 1 min, 3 at 5 min and 7 at 10 min), resuscitation with naso-tracheal intubation and immediate mechanical ventilation in the delivery room resulted in rapid improvement and haemodynamic stabilization. The amniotic fluid was meconiumstained. On admission to our intensive care unit, infant hypertonia with some 'rolling-up' movements of upper limbs was noted and therefore treatment with Phenobarbital was commenced. Otherwise, the clinical examination revealed a massive umbilical cord haematoma at the skin junction, which was compressing the cord.Postnatal evolution showed a neurological degradation with coma, no reactivity, total hypotonia and no archaic reflex. Electroencephalogram obtained during the second day of life revealed a severe alteration in brain electrogenesis compatible with hypoxic-ischemic encephalopathy. Cerebral ultrasonography showed a diffuse cerebral oedema. The third day, magnetic resonance imaging (MRI) confirmed cortical and basal ganglia ischemic lesions.The newborn remained dependant on mechanical ventilation and died of multi organ failure on day 6 of life.Biological assessment showed a disseminated int...

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Candiduria is rare in newborns and infants, occurring most often in patients with risk factors. When associated with a candidal bezoar in the urinary tract, candiduria is usually treated by systemic amphotericin B and flucytosine plus local irrigation with amphotericin B. We describe the successful treatment of five newborns with a urinary tract infection, on major urological malformations, due to Candida albicans (including three with a candidal bezoar) by fluconazole alone. No adverse effects or recurrences were observed. Fluconazole therapy permits early discharge from the hospital and seems suitable for infants and newborns with a C. albicans urinary tract infection.

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Objectives: To evaluate the positive threshold of PCT for neonates of <32 weeks of gestation for the diagnosis of early-onset sepsis and to determine if the level of PCT collected within 6 h of life could be used.Design: Retrospective and bicentric study from May 2016 to April 2018.Setting: Two groups were established, neonates evaluated for PCT at birth (CordPCT) and within 6 h of life (delPCT).Patients: Two hundred and sixty neonates of <32 weeks of gestation born in Nice and South Paris (Bicêtre) University Hospitals, had been evaluated for PCT level.Main Outcomes Measures: The value of the PCT positive threshold was determined for the total population and each groups thanks ROC curves.Results: The threshold level of PCT for the total population was 0.98 ng/mL. The threshold value of cordPCT group was 1.00 vs. 0.98 ng/mL for delPCT group. The area under the Receiver Operating Characteristics curve for PCT sampled in delPCT group was significantly higher than in cordPCT group (0.94 compared to 0.75).Conclusions: The threshold level of PCT was higher in this cohort of neonates of <32 weeks of gestation compared to the value generally described for term neonates. The secondary sampling PCT level seems to be usable in screening algorithm for early-onset neonatal sepsis.