Subject(s)
Actinomycetales Infections/diagnosis , Cough/etiology , Whooping Cough/diagnosis , Child, Preschool , Diagnosis, Differential , Female , Humans , Infant , MaleABSTRACT
No disponible
Subject(s)
Child, Preschool , Humans , Actinomycetales Infections/diagnosis , Cough/etiology , Whooping Cough/diagnosis , Diagnosis, DifferentialABSTRACT
We present a case of bacterial tracheitis in a 6.5 year old girl. Clinical signs and symptoms consisted of severe croup with high grade fever, which were preceded by upper respiratory tract prodrome. Initial treatment with steroids and nebulized epinephrine was unsuccessful. The patient was intubated a few hours after admission. Thick purulent secretions emerging from the trachea and the normal appearance of the epiglottis suggested the diagnosis of bacterial tracheitis, which was confirmed by isolation of Haemophilus influenzae in the culture of the tracheal secretions. The patient was administered a 14 day course of endovenous ceftriaxone and was kept on mechanical ventilation for 7 days. Fever and purulent tracheal secretions continued for the next 5 days. After 48 hours without these signs, laryngotracheobronchoscopy ruled out residual obstruction. Extubation was successfully performed. Fourteen days later physical examination showed no abnormalities and the patient was discharged. No complications were found during followup. The clinical, diagnostic and therapeutic aspects of this potentially life threatening entity that should taken into account in the differential diagnosis of severe croup are discussed.
Subject(s)
Haemophilus Infections , Haemophilus influenzae , Tracheitis/etiology , Ceftriaxone/administration & dosage , Ceftriaxone/therapeutic use , Cephalosporins/administration & dosage , Cephalosporins/therapeutic use , Child , Croup/diagnosis , Croup/drug therapy , Female , Follow-Up Studies , Haemophilus Infections/diagnosis , Haemophilus Infections/drug therapy , Humans , Respiration, Artificial , Time Factors , Tracheitis/diagnosis , Tracheitis/drug therapy , Tracheitis/therapyABSTRACT
Se presenta un caso de traqueítis bacteriana en una niña de 6 años y medio. La forma clínica de presentación fue la de un crup intenso con fiebre alta y pródromos catarrales en los días previos, que no respondió al tratamiento inicial con adrenalina inhalada y corticoides y precisó intubación orotraqueal a las pocas horas del ingreso. La visualización de secreciones purulentas fluyendo de la tráquea en el momento de la intubación, con epiglotis de aspecto normal, orientó el diagnóstico de traqueítis bacteriana, que fue confirmado por el crecimiento de Haemophilus influenzae en el cultivo de dichas secreciones. Se administró tratamiento con ceftriaxona por vía intravenosa durante 14 días y ventilación mecánica durante 7 días. La fiebre alta y las secreciones traqueales purulentas persistieron durante los 5 primeros días de tratamiento. A los 2 días de desaparición de dichos signos, y previa laringotraqueobroncoscopia normal, se extubó con éxito. Tras 2 semanas de ingreso fue dada de alta con exploración física normal, y no se han observado complicaciones posteriores. Se revisan aspectos clínicos, diagnósticos y terapéuticos de una enfermedad que puede conllevar un compromiso vital y que debe considerarse en el diagnóstico diferencial de todo crup grave (AU)
Subject(s)
Child , Male , Female , Humans , Haemophilus influenzae , Haemophilus Infections , Tracheitis , Time Factors , Granuloma Annulare , Respiration, Artificial , Cephalosporins , Ceftriaxone , Croup , Follow-Up StudiesABSTRACT
El control posnatal del feto con pielectasia ha sido objeto de controversia en la bibliografía reciente. La definición de pielectasia, la necesidad de estudiar o no a todos estos recién nacidos con el objetivo teórico de prevenir la nefropatía por reflujo y las infecciones urinarias, qué exploraciones hacerles y cuándo (ecografía posnatal, cistografía sistemática, estudios isotópicos), y si es necesario someterlos o no a profilaxis antibiótica, son aspectos que no están suficientemente aclarados. Tampoco la relación entre pielectasia prenatal, reflujo vesicorrenal e infección parece lineal. Este artículo intenta ordenar las controversias actualmente existentes al respecto, comentando finalmente el papel de las alteraciones genéticas en el desarrollo de los distintos tipos de nefropatía y malformaciones renales (AU)
Subject(s)
Pregnancy , Infant, Newborn , Female , Humans , Urinary Tract Infections , Vesico-Ureteral Reflux , Prenatal Diagnosis , Dilatation, Pathologic , Hydronephrosis , Kidney Pelvis , Fetal Diseases , Follow-Up Studies , Gestational AgeABSTRACT
Postnatal followup of fetal pyelectasis is a controversial topic in recent literature. Questions such as the definition of pyelectasis, whether these neonates should be selected for postnatal study in an attempt to prevent reflux nephropathy and urinary tract infections, which complementary investigations (postnatal ultrasonography, cystourethrography, isotopic studies) should be performed and when, and whether these neonates should be administered antibiotic prophylaxis are unresolved issues. In addition, the relationship between prenatal pyelectasis, vesicoureteral reflux and infections is not at present clear. In this article, we try to review and order the present controversies, and briefly introduce the role of genetic aspects in the origin of different forms of nephropathy and renal malformations.
Subject(s)
Fetal Diseases/diagnosis , Hydronephrosis/diagnosis , Kidney Pelvis/abnormalities , Vesico-Ureteral Reflux/prevention & control , Dilatation, Pathologic , Female , Follow-Up Studies , Gestational Age , Humans , Infant, Newborn , Pregnancy , Prenatal Diagnosis , Urinary Tract Infections/prevention & controlSubject(s)
Drug Resistance, Microbial , Animals , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/pharmacology , Anti-Bacterial Agents/therapeutic use , Bacteria/drug effects , Cattle , Chickens , Data Collection , Dogs , Drug Industry , Drug Prescriptions , Drug Resistance, Multiple , Drug Utilization , Humans , Penicillin Resistance , Primary Health Care , Sheep , Spain , Swine , Time Factors , Turkeys , Vaccines/administration & dosage , Veterinary MedicineABSTRACT
A new case of neonatal 3-hydroxy-3-methylglutaric aciduria is described. 3-hydroxy-3-methylglutaryl CoA lyase activities in leukocytes demonstrated the patient's homozygosity and the heterozygous character of the parents and two other members of the family. Dietetic management with low fat high carbohydrate diet together with protein restriction and carnitine resulted in a good control of the metabolic acidosis, the hypoglycemia, and the physical and neurological development. Nevertheless, sudden death occurred at the age thirteen months without any previous apparent trouble and the necropsia showed neither signs of infection nor hepatic or cardiac derangement.
Subject(s)
Acidosis/enzymology , Death, Sudden/etiology , Hydroxymethylglutaryl-CoA Synthase/deficiency , Oxo-Acid-Lyases/deficiency , Homozygote , Humans , Hypoglycemia/enzymology , Infant , Infant, Newborn , Ketosis/enzymology , Leukocytes/enzymology , MaleABSTRACT
We report an original nomogram to calculate the caloric contribution in the newborn using milliliters of milk and its concentration. Formula usually contain 5 kcal/g of milk. It could be utilized for intervals every two, three and four hours.
Subject(s)
Energy Intake , Infant Food , Infant, Newborn/physiology , Algorithms , Humans , Infant Nutritional Physiological Phenomena , Nutritional RequirementsABSTRACT
The case presented is that of a newborn with palpable renal masses and oliguria that lasted for the first five days of live. The pyelography that was perfomed showed a prolonged tubular nephrogram and a light increase in kidney size. The good general state, normal test results, a kidney biopsy which failed to show any histological changes and its favorable development, suggested a diagnosis of transitory tubular obstruction caused by protein casts. It is suggested the diagnosis of the Tamm Horsfall proteinuria in the light of the works published in which similar case histories and urograms were cited. These works proved the presence of Tamm Horsfall mucoprotein by the use of specific immunofluorescence tests.
