C-reactive protein in measles.

Seventy-two children with early measles (1st-3rd day of rash), presenting at two centres in Santiago, Chile, were classified as having mild ('ordinary measles', n = 50), or moderate to severe measles ('primarily severe measles', n = 22). The level of serum C-reactive protein (CRP) was determined by nephelometry from a finger prick sample. The mean CRP value in ordinary measles, 19 mg/l, was significantly lower (P less than 0.001) than in primarily severe measles where the mean CRP was 65 mg/l. During late measles (5th-8th day of rash), the mean CRP was 19 mg/l if the child recovered uneventfully (n = 35), whereas the mean level of 123 mg/l (P less than 0.001) was encountered when the child suffered from complicating pneumonia (n = 22). We conclude that the simple quantitative CRP determination is a useful alarm signal during the course of measles: elevated levels point to severity or complications in recovery.

[Indomethacin in the treatment of patent ductus arteriosus in premature newborn infants]. / Indometacina en el tratamiento del ductus arterioso persistente en recién nacidos prematuros.

The effectiveness of indomethacin versus usual medical treatment with fluid restriction to 75% of the volume given in the previous days, with or without frusemide (UMT), for the closure of hemodynamically significant patent ductus arteriosus (HSPDA) was retrospectively studied in 87 premature infants under 2,000 g admitted to our nursery from year 1978 throughout 1988. Among 16 babies, treated from the beginning with indomethacin and UMT, HSPDA was closed 72 h later in 14 (87.5%), versus only 14 closures in 71 babies (19.7%) treated by UMT alone (p < 0.01). Of the 57 babies whose HSPDA failed to close with UMT alone, 23 were given indomethacin and successful closure was seen in 16 (69.6%), while among 34 babies remaining on UMT alone, closure resulted in only 7 (20.6%) (p < 0.01). Intravenous route for administration and early use of indomethacin (before age 7 days) proved to have significantly higher success rates than oral route and use of the drug after age 7 days.

[Congenital tuberculosis]. / Tuberculosis congénita.

Congenital tuberculosis is a rare disease of variable incidence in accordance with prevalence of the disease in the general population. We report a case in a neonate born prematurely, whose mother presented with miliary tuberculosis diagnosed in the puerperal period. The newborn had no contact with his mother after delivery, neither with other infected people. The clinical picture consisted mainly in signs and symptoms of septicaemia of gradual onset. Mycobacterium tuberculosis was isolated from gastric fluids and the response to specific treatment, was excellent. Although congenital tuberculosis is a rare disease, is should be suspected in any neonate developing signs and symptoms of sepsis of unknown etiology. The importance of an early diagnosis and treatment is stressed in order to improve neonatal survival.