The first case of a newborn infant with a cephalhematoma infected by a species of Bacteroides is presented. Previously reported cases of infected cephalhematomata are reviewed and Bacteroides infections in children are discussed.Cephal hematoma in the newborn infant results from an accumula¬ tion of blood between the bone and periosteum. The reported incidence varies from 0.4% to 2.5%.'·2 Cephalhematomas are more frequent in male than female subjects by a ratio of 3:2; in 70% of cases the mothers are primiparous, and the lesion oc¬ curs more commonly over the right than the left parietal bone.1 Cephal¬ hematoma is generally a benign con¬ dition and usually resorbs in a few weeks, although the characteristic crater ring may persist for much longer periods both on physical ex¬ amination and roentgenogram. Bac¬ terial infection of a cephalhematoma is rare. In this paper such infections are reviewed and a case of a cephal¬ hematoma infected with a species of Bacteroides is described. It would ap¬ pear that this is the first reported in¬ stance of a cephalhematoma infected by this organism.A male infant weighing 3,122 gm (6 lb 14 oz) was born at term to a 28-year-old primigrávida following a normal preg¬ nancy and an eight-hour labor. The infant was delivered vaginally under local anes¬ thesia following rotation from a left occi¬ put transverse position to a right occiput anterior position by low forceps. Apgar scores were 8 and 9 at one and five min¬ utes, respectively.On initial examination the infant was vigorous. The only pertinent finding was a 10x8 cm right parietal cephalhematoma. The huge mass was well demarcated, tense, and nonpulsatile. Skull roentgen¬ ograms revealed no fractures. The infant seemed well until the fifth day, when jaundice was noted and the total serum bilirubin level was 17.4 mg/100 cc, of which 1.1 mg was conjugated. The mater¬ nal and infant blood types were Rh posi¬ tive. Direct Coombs' test was negative.He was afebrile and showed no clinical evidence of sepsis. Fluorescent photother¬ apy was started, and jaundice gradually disappeared. The size of the cephalhema¬ toma did not increase significantly, but the mass became somewhat tense and the overlying skin became shiny and lustrous.There was no scalp infection. On the tenth day his temperature rose to 101.8 F (38.6 C); he vomited three times and appeared somewhat irritable, but remained vigor¬ ous with a good sucking reflex. The he¬ matocrit reading, white blood cell count, and differential were normal. About 75 cc of bloody fluid was aspirated from the cephalhematoma for diagnostic purposes and to prevent ischemie necrosis of either the overlying scalp or underlying bone. Following the aspiration, vomiting ceased and the infant became afebrile and less irritable. The aspirate grew a pure culture of a species of Bacteroides. Because of the unusual type of organism, a second aspi¬ ration was performed on the 12th day, and that aspirate also grew a pure culture of Bacteroides; on the same day he was treated with kanamycin sulfate and aqueo...
difference between the 2 groups was not statistically significant ( p = . 5 ) . Both groups were quite hypertensive, since normal male Wistar rats of the same age have an average blood pressure of approximately 105 mm Hg.
Conclusions.These results indicate that in rats under these conditions, presence or ahsence of adrenal tissue has no effect on the severity of hypertension produced by desoxycorticosterone administration.
Physiological and social criteria were used in discharging 170 newborns weighing 2,268 gm (5 lb) or less at birth from the hospital at an average weight of 2,062 gm (4 lb 8\m=3/4\oz). Criteria for discharge did not include attainment of any specific weight. Mean hospital stay was 12 days. Follow-up of 167 infants revealed that none had died within two months of discharge. The rationale for reducing length of hospitalization is to expedite, encourage, and thereby enhance early maternal-infant relationships. Reducing the risk of hospital-associated infection, and economy in nursing time and dollar savings are fortuitous by-products. We question widespread practices regarding length of hospitalization of low-birth-weight infants.
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