Low mortality in necrotizing enterocolitis associated with coagulase-negative Staphylococcus infection.

The aim of this study was to correlate the clinical course of necrotizing enterocolitis (NEC) with infection by coagulase-negative Staphylococcus at the onset of the illness. Records of all newborn infants developing NEC between January 1998 and December 2001 were reviewed. NEC was classified according to the criteria of Bell et al. Numeric variables were described by standard statistical methods. Comparisons between subgroups were performed by parametric statistical tests. Forty-four patients developed NEC stage II (n = 25) or III (n = 19). The incidence was 0.024% of live births in the hospital, and the mortality rate was 9%. The main risk factor was prematurity (84%). Only one-fourth of the patients had gastric residuals. A platelet count of <100,000 cells/mm3 occurred only in grade III NEC. Blood cultures were positive in 34% of the patients. The predominant organism (73%) was coagulase-negative Staphylococcus (CoNS). Neither Clostridium nor Bacteroides species were isolated. Stage II patients were maintained nothing per os (NPO) for 9 +/- 3 days and received antibiotics for 10 +/- 3 days. All of the stage III patients required an operation. In one-third of them, primary peritoneal drainage was initially performed but all required further operative procedures. We report a low incidence and mortality rate of necrotizing enterocolitis. Thrombocytopenia is confirmed as a marker of severity. Positive blood cultures for CoNS may explain, at least in part, the low mortality reported.

Aneurisma idiopático de aorta abdominal en una paciente de 8 años de edad / Idiopathic abdominal aortic aneurysm in an 8-year-old female patient

Introducción. Los aneurismas aórticos son una entidad excepcional en la edad pediátrica y, habitualmente, se presentan asociados a otras enfermedades. Caso clínico. Paciente de sexo femenino, de 8 años de edad, que acudió al hospital con una historia de dolor abdominal y la presencia de una masa hipogástrica pulsátil que correspondía a un aneurisma aórtico gigante. Conclusión. Ante la excepcionalidad de la patología, tanto el diagnóstico como un tratamiento quirúrgico precoz fueron las claves para la completa recuperación de la paciente. La elección correcta de la técnica quirúrgica y los materiales usados probablemente permitieron el crecimiento sin la aparición de problemas derivados de la prótesis (AU)

INTRODUCTION. Abdominal aortic aneurysms are very rare in children. They are usually associated with well-known medical conditions but some are idiopathic. CASE REPORT. An 8-year-old girl who was admitted to hospital with abdominal pain and a large abdominal pulsatile mass corresponding to a large aortic aneurysm. CONCLUSION. An accurate diagnosis and a prompt surgical treatment led to a quick and successful recovery. A right choice of both, surgical technique and prosthetic material, probably let a free-complication growth-up of this patient (AU)