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RESUMOA artrite meningocócica primária, isolada de contexto de sépsis meningocócica, é um fenómeno raro, em especial na idade pediátrica. O atingimento monoarticular é ainda menos frequente nas infecções a Neisseria spp. Apresentamos o caso de lactente de 2 meses de idade, sexo feminino, caucasiana, apresentando quadro de febre elevada com 4 dias de evolução e choro durante a manipulação do membro inferior esquerdo na muda de fralda. Sem sépsis clínica ou analiticamente. Sem vacinação anti-meningocócica prévia. A ecografia articular revelou presença de líquido intra-articular. O exame bacteriológico do drenado purulento por artrotomia foi positivo para Neisseira meningitidis. Apresentou boa resposta à antibioterapia e evolução favorável após a alta. A artrite séptica meningocócica, ainda que rara, constitui uma urgência pediátrica, e é diagnóstico diferencial perante uma criança com quadro febril e queixas articulares. Palavras-chave: Artrite Infecciosa; Infecções Meningocócicas; Lactente; Neisseria meningitidis.
ABSTRACTMeningococcal septic arthritis, ocurring without signs of sepsis, is rare, including at pediatric age. The confinement of infection to a single articulation (monoarticular form) is even rarer in infections by Neisseria spp. We discuss the case of a two month-old caucasian girl, presenting with fever and persistent crying during nappy change. Absence of clinical sepsis was notable. She had had no previous anti-meningococcal immunizations. The ultrasound of the left hip revealed the presence of intra-articular fluid. Culture of the purulent sample after drainage by arthrotomy produced Neisseria meningitidis. She had a good clinical response to the antibiotics. Follow-up showed no sequels. Albeit a rare entity, primary meningococcal arthritis is a mandatory differential diagnosis concerning a feverish child with articular complaints.
Background: Malformations of the skull base are rare anomalies, but can cause severe complications such as meningitis. They are often detected not until after a history of recurrent meningitis.
Introduction:Neonatal pneumonia is one of the most common infl ammatory processes in newborns. Microbiological examination of the lower respiratory tract identifi es and guides the selection of antibacterial therapy. To analyze tracheal aspirates in newborns with congenital pneumonia, and compare them with clinic, laboratory and radiographic changes.Methods: A retrospective study was carried out from 1. 01.2018 to 31.12.2018 at Neonatology Clinic, University O&G hospital "Maichindom", Sofi a. The study included 194 newborns treated immediately after birth by invasive mechanical ventilation in the NICU. The infants were divided into groups according to their body weight. Tracheal aspirates were taken immediately after birth. We analyzed them, along with clinical-laboratory data, the treatment and the average stay.Results: 22 positive primary tracheal aspirates (11%) were isolated with predominant Gram-negative bacteria (E.coli, S.marcescens, Achromobacter spp),and isolates of S.epidermidis, Str.viridans, C.parapsilosis. In 89% of tracheal aspirates taken immediately after birth were sterile. All patients had radiographic pulmonary changes and most of them-infl ammatory activity(increased CRP-66% and leukopenia-36%).132 patients(68%)were treated with Surfactant. The following complications were identifi ed:10 infants with pneumothorax, 2-with late Candida sepsis and acute renal failure. Two of the newborns were diagnosed with CMV and HSV2 infection with active viral replication(PCR).Standard antibiotic treatment-10day course (Ampisulbactam + Amikin) was administered to all patients. In 72% there were follow-up courses according to clinical complications and antimicrobial susceptibility.Conclusions: Standard microbiological tests fi nd out the specifi c bacterial agent, but others such as chlamydia, viruses and parasites remain undiagnosed. The antibiotic prophylaxis of mothers at the time of delivery reduces etiological evidence of congenital pneumonia.
Introduction:Neonatal sepsis is an important cause of neonatal morbidity and mortality. The spectrum of microbial etiology of neonatal septicaemia varies from region to region and even varies in different hospitals of the same region. In addition, one organism or group of organisms may be replaced by others over a period of time. The present study examines the trends in bacterial profi le and antibiotic resistance of the organisms causing early-onset sepsis in the neonates at a tertiary perinatal center in Bulgaria.Methods: A retrospective laboratory-based analysis of blood cultures obtained from Neonatal Intensive Care Unit of a tertiary care hospital in Sofi a was done for the period of 2008-2018, divided into two phases.Results: A total of 3335 isolates were considered. Over time, methicillin-resistant (MR) organisms have replaced methicillin-sensible (MS) as frequent isolates. Initially, there was predominance of MS Staphylococcus aureus and MS Staphylococcus epidermidis, which recently has been changed with coagulase negative-Staphylococcus aureus and MR Staph...
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