[Perinatal listeriosis. Apropos of two cases]. / Listeriosi perinatale. A proposito di due casi.

Two cases of perinatal listeriosis are reported by the Authors. The Authors emphasize that in Italy the incidence of this disease is undervalued. Additionally, the pregnant woman comes to be affected by forms which do not clinically fall within standard levels and whose course does not get worse over a certain limit. On the other hand, the fetus suffers substantial damages like abortion, premature labour with its subsequent failure or in case with a fetus affected by listeriosis. Two main clinical forms do exist in the neonatal period: the early form that is the septicemic form and the later form that is the meningitic form. As regards therapy on newborn, the Authors report that a mixture of Ampicillin and Aminoglycosides turns out to be successful for recovering patients from listeriosis. Furthermore, the Ampicillin together with a general igienic therapy are a good protection for the fetus and newborn in a pregnant woman.

[Therapy of neonatal infection caused by group B beta-hemolytic Streptococcus]. / La terapia dell'infezione neonatale da streptococco beta-emolitico di gruppo B.

Expectant therapy for early Group B Streptococcus onset septicemia must provide coverage against other microorganism, such as L. Monocytogenes, H. Influenzae and S. Pneumoniae. It is possible to administer a combination of antimicrobial agents with activity against all or the most likely pathogens. Thus initial expectant therapy includes a broad spectrum semisynthetic penicillin (e.g. ampicillin) and an aminoglycoside (e.g. netilmicin). Vancomicin, teicoplanin and cefotaxime may also be used. Supportive therapy consists on temperature control, i.v. administration of fluids, acid-base balance and electrolytes monitoring, seizures control and ventilation. IV immunoglobulins, granulocyte and serum transfusion are also used. The G-Colony Stimulating Factor (G-CSF, filgastrim) usage is also reported.

[Retropharyngeal abscess in nursing infants. Report of 2 cases]. / Ascesso retrofaringeo nel lattante. A proposito di 2 osservazioni.

The authors report two cases of retropharyngeal abscess in breast-fed babies and highlight the salient points of the disease: 1) The disease is rare, severe and sometime atypical. 2) The clinical features are: the patient age (breast-fed babies), difficult in swallowing, drooling, dyspnea and malaise. 3) The diagnosis is confirmed by a forward movement of the pharynx and of the soft palate except when the abscess is located on the lower half of the retropharyngeal space. 4) The most important diagnostic procedure is the lateral radiography of the neck that shows a widening of the retropharyngeal prevertebral space. 5) If an adequate therapy is not undertaken, following complications are possible: opening of the abscess with passage of the pus into the bronchopulmonary space, obstructive dyspnea with oxygen lack, propagation of the abscess into the mediastinum and possible development of fistulas into lung, and pleura, and exceptionally into pericardium. 6) The therapy includes the use of drugs active toward the possible etiological agents: the most common are the S.B.E.A., anaerobes, staphylococcus and gram-negative. At stage of suppuration, surgical operation is required.