ABSTRACT
Intrauterine infections are associated with life-threatening neonatal conditions such as sepsis, intracranial hemorrhage, and chronic lung disease. Herein we present a case of generalized congenital folliculitis caused by Pseudomonas aeruginosa in a preterm neonate of 27 weeks gestational age successfully treated with antibiotics. Folliculitis is an important manifestation of intrauterine P. aeruginosa infection, and prompt, effective treatment is crucial to ensuring a good prognosis.
Subject(s)
Folliculitis/congenital , Infant, Premature , Pseudomonas Infections/congenital , Pseudomonas aeruginosa/isolation & purification , Anti-Bacterial Agents/administration & dosage , Folliculitis/drug therapy , Folliculitis/microbiology , Humans , Infant, Newborn , Male , Pseudomonas Infections/drug therapy , Pseudomonas Infections/microbiology , Treatment OutcomeABSTRACT
OBJECTIVE: To evaluate the diagnostic value of anti-microbial peptide (cathelicidin), LL-37, in congenital pneumonia and its relation to 25 hydroxycholecalciferol [(25 OH)D] status. METHODS: The study included 30 neonates with congenital pneumonia and culture proven sepsis admitted to neonatal intensive care unit of Ain Shams University and 30 healthy neonates as control group. All neonates were subjected to history taking, clinical examination and measurement of serum 25(OH)D and cathelicidin. RESULTS: Neonates with congenital pneumonia had significantly higher serum cathelicidin and lower serum 25(OH)D compared to controls. Serum cathelicidin was negatively correlated with Apgar score at 1 and 5 min and positively correlated with length of stay among patient group. CONCLUSION: Cut-off value of cathelicidin to diagnose congenital pneumonia was 17 pg/mmol with 93% sensitivity and 86% specificity. Neonates with congenital pneumonia had significantly high cathelicidin and low 25(OH)D suggesting a possible role of fetal 25(OH)D deficiency as predisposing factor for congenital pneumonia.
Subject(s)
Antimicrobial Cationic Peptides/blood , Pneumonia, Bacterial/diagnosis , Vitamin D Deficiency/complications , Biomarkers/blood , Calcifediol/blood , Case-Control Studies , Escherichia coli Infections/blood , Escherichia coli Infections/congenital , Escherichia coli Infections/diagnosis , Female , Humans , Infant, Newborn , Klebsiella Infections/blood , Klebsiella Infections/congenital , Klebsiella Infections/diagnosis , Klebsiella pneumoniae/isolation & purification , Male , Pneumonia, Bacterial/blood , Pneumonia, Bacterial/congenital , Pneumonia, Pneumococcal/blood , Pneumonia, Pneumococcal/congenital , Pneumonia, Pneumococcal/diagnosis , Pseudomonas Infections/blood , Pseudomonas Infections/congenital , Pseudomonas Infections/diagnosis , Risk Factors , Sensitivity and Specificity , Staphylococcal Infections/blood , Staphylococcal Infections/congenital , Staphylococcal Infections/diagnosis , Vitamin D Deficiency/blood , Vitamin D Deficiency/congenital , Vitamin D Deficiency/diagnosis , CathelicidinsABSTRACT
Group B streptococci and Escherichia coli are the most frequently isolated etiologic agents in neonatal septicemia. Neonatal infection that is caused by Pseudomonas aeruginosa is usually late in onset, nosocomial in origin and epidemic in pattern. However, P. aeruginosa must be considered in all neonatal infections, regardless of the age of onset, so that early, appropriate and often lifesaving antibiotic therapy may be instituted.
Subject(s)
Pseudomonas Infections/congenital , Sepsis/etiology , Adult , Amikacin/therapeutic use , Ampicillin/therapeutic use , Female , Humans , Infant, Newborn , Kanamycin/therapeutic use , Male , Pregnancy , Pseudomonas Infections/therapy , Sepsis/congenital , Sepsis/therapy , Ticarcillin/therapeutic useABSTRACT
Pseudomonads are common causes of nosocomial infections but are rarely implicated in perinatal disease. In a retrospective autopsy study we found that 9% of all acute congenital bacterial infections were due to Pseudomonas species. Premature rupture of membranes occurred in half the cases and clinical maternal amnionitis in two-thirds. One case was apparently nosocomial in origin. No known risk factors were implicated in any other case. Seven infants were stillborn and two died within a few hours. Congenital pneumonia, funisitis, and chorioamnionitis were found at autopsy. Intrauterine infection due to the pseudomonads poses a serious problem that has not been previously recognized.
Subject(s)
Fetal Death/etiology , Infant Mortality , Pseudomonas Infections/congenital , Female , Humans , Infant, Newborn , Male , Pneumonia/congenital , Pneumonia/etiology , Pregnancy , Retrospective Studies , Sepsis/congenital , Sepsis/etiologySubject(s)
Infant, Newborn, Diseases/microbiology , Pseudomonas Infections/microbiology , Sepsis/microbiology , Anti-Bacterial Agents/therapeutic use , Female , Humans , Infant, Newborn , Infant, Newborn, Diseases/drug therapy , Pseudomonas Infections/congenital , Pseudomonas Infections/drug therapy , Sepsis/congenital , Sepsis/drug therapyABSTRACT
The case is presented of a premature infant with Pseudomonas aeruginosa infection, apparently acquired in utero. After a complicated postnatal course, the child was noted to have a profound hearing loss. This infection itself, was rapid and progressive, with the infant showing signs and symptoms characteristic of Pseudomonas infection, such as necrotizing skin vasculitis and "green" purulent discharge. Pseudomonas infection poses a virulent and life-threatening challenge to the immunologically immature infant. Infection with this organism, uncommon in the neonate, results in significant morbidity and mortality.
