Orbital cellulitis caused by community-associated methicillin-resistant Staphylococcus aureus in a previously healthy neonate.

A 30-day-old, previously healthy, near-term neonate presented with fever and swelling of the left eye. Orbital cellulitis of the left eye was diagnosed by computed tomography. Both blood culture and pus that was drained from the orbital abscess were positive for methicillin-resistant Staphylococcus aureus (MRSA), which was found to be a strain indigenous to the local community by a molecular method. Using vancomycin therapy and surgical drainage, the infant recovered uneventfully. Orbital cellulitis in neonates may rapidly progress to abscess formation, even to sepsis, and S. aureus is the most common pathogen. With the increasing prevalence of community-associated MRSA, empiric antibiotics effective against MRSA should be first considered in endemic areas.

Effect of body weight on temperature control and energy expenditure in preterm infants.

BACKGROUND: The purpose of this study was to compare resting energy expenditure (REE) in premature infants of different body weights during weaning from the incubator. We hypothesized that premature infants would respond to weaning from an incubator with an increase in REE, and that the increment would be larger in infants with lower body weights than in those with higher body weights. METHODS: Stable preterm infants with body weights between 1800-2200 g were enrolled. REE was measured using indirect calorimetry at 1 hour before weaning and 3 hours after turning off the incubator. REE measurements from infants with higher body weight (2000-2200 g, Group A) were compared to those of infants with lower body weight (1800-2000 g, Group B). RESULTS: A total of 22 patients were studied (10 in Group A and 12 in Group B). REE increased significantly after weaning in both groups (Group A: from 62 +/- 7 kcal/kg/day to 69 +/- 8 kcal/kg/day, p = 0.045 and Group B: from 65 +/- 5 kcal/kg/day to 70 +/- 7 kcal/kg/day, p = 0.001). However, there was no significant difference in REE increments between the two groups. CONCLUSION: REE increased significantly in infants during weaning from an incubator. The increase in REE increment was similar in smaller (1800-2000 g) and larger (2000-2200 g) babies in this study. Weaning of preterm babies from an incubator may be safely started when their body weight reaches 1800 g.

Streptococcus pneumoniae-associated haemolytic uremic syndrome following influenza A virus infection.

Influenza virus is a seasonal cause of community-acquired pneumonia, and Streptococcus pneumoniae is one of the most common pathogens causing secondary bacterial pneumonia. S. pneumoniae-induced haemolytic uremic syndrome is an uncommon condition mainly observed in young children. We present a patient who had invasive pneumococcal disease and haemolytic uremic syndrome. Simultaneous viral cultures grew influenza A. To the best of our knowledge, this is the first such reported case.