Outcomes of antenatally detected renal pelvic dilatation: A retrospective study.

Background Renal pelvic dilatation is one of the abnormalities detected antenatally by ultrasound scan (USS), incidence being around 0.5-1% of live births. In most children it is benign. Objectives To determine the local occurrence and outcomes of antenatally detected renal pelvic dilatation and to determine whether there is a sex difference in the incidence and outcomes Method The 18-20 weeks morphology scans of all live newborn babies delivered in the maternity ward of Hervey Bay hospital from 01/02/2008 to 30/09/2008 were retrospectively analysed. Infants with antenatally detected renal pelvic dilatation were followed up with 2 weeks postnatal USS. Infants with increasing pelvic dilatation or persistent moderate to severe dilatation were followed up with MCUG / MAG 3 scan. Results Total number of live births during the 8 month period was 695. There were 362 males and 333 females. There were 15 (2.2%) neonates (7 male, 8 female) with antenatally detected renal pelvic dilatation. Occurrence in males was 1.9% and females 2.4% (p =0.671). Five cases were bilateral and 10 unilateral. In unilateral cases, left side involvement was more common (60%). In bilateral cases left side involvement was more severe in 60%. There were 9 (60%) cases with mild dilatation, 4 (27%) with moderate dilatation and 2 (13%) with severe dilatation. Oligohydramnios, thickened bladder or dilated ureters were not detected in any of the cases. Caliectasis was detected in 2 infants (13.3%) who had severe dilatation in antenatal scan. Subsequent postnatal scan was completely normal in 6 (40%), improved in six (40%) and worse in three (20%). There were 4 cases with mild, 2 with moderate and 3 with severe dilatation. All infants with severe dilatation had caliectasis. MCUG was done in 3 infants but did not detect any abnormality or reflux. Antibiotic prophylaxis was stopped after normal MCUG. MAG 3 scan was done in 3 infants including one with normal MCUG and all three detected PUJ obstructions but none required surgery. All 3 infants with PUJ obstruction had either severe (2) or moderate (1) dilatation on antenatal scan and all 3 had severe dilatation on postnatal scan. Of these 3 infants with PUJ obstruction, 2 had caliectasis in antenatal scan and all 3 had caliectasis in the subsequent postnatal scan. Follow up period varied from 1 to 9 months. None developed symptomatic UTI during this period. Conclusions There were 2.2% neonates with antenatally detected renal pelvic dilatation. Outcome was satisfactory in 80% of cases. There was no significant sex difference in occurrence or outcome.

Fatal septicaemia caused by Chromobacterium violaceum.

We report a case of Chromobacterium violaceum septicaemia in a 10-year old boy admitted to hospital in September 2001, two weeks after he suffered a crush injury of the left foot. In spite of surgical debridement and antibiotics his condition worsened and he developed multiple liver and lung abscesses. He died one week after admission and a blood culture grew Chromobacterium violaceum.