Tuberculosis in pregnancy with fatal congenital infection.

An unusual case of miliary tuberculosis which presented as fever and a tubo-ovarian abscess in a postpartum patient is described. Fatal congenital tuberculosis was also diagnosed in the mother's premature infant. The difficulties encountered in diagnosing the tuberculosis in these patients are summarized, and the need for early recognition and therapy is emphasized. Epidemiologic follow-up of the premature infant's exposed contacts was thorough and revealed no new cases of tuberculosis among the infants or the personnel who were exposed to the infected baby.

Postnatal acquisition of herpes simplex virus by the newborn infant: a review of the literature.

The literature relating to the hazards of herpes simplex virus acquired by newborn infants after birth is reviewed. A total of 24 infants has been reported who have acquired the infection in this manner; 66% of these infants expired. Transmission of virus from mothers, adults (including personnel) other than the mother, and other infants has been reported. In order to prevent this infrequent but life-threatening illness, separation of the newborn infant from any person with active lesions caused by herpes simplex virus is recommended.

Transmission of herpes-simplex virus type 1 in a nursery for the newborn. Identification of viral isolates by D.N.A. "fingerprinting".

The occurrence of herpes-simplex-virus type-1 infections in two newborn infants in a nursery within a one-month period suggested the possibility of transmission in the nursery. One infant may have been infected by his father, who had active herpes labialis at the time of the child's birth. The source of the second infant's infection was not apparent. Viruses isolated from the two infants were "fingerprinted" by cleaving the virus-specific D.N.A. with several restriction endonucleases and comparing the electrophoretic patterns. Isolates from the two infants were identical and differed from other isolates from epidemiologically unrelated cases. This observation confirmed the possibility of transmission of herpes-simplex virus type 1 in the nursery, but did not define the mode of transmission. Type-1 infections are serious in neonates: one of the infants died and an oesophageal stricture developed in the other. The "fingerprinting" technique provides a useful epidemiological technique for tracing the transmission of herpes virus infections.

Prune-belly syndrome associated with Potter (renal nonfunction) syndrome.

Three fatal cases of prune-belly syndrome were associated with nonrenal features of Potter syndrome. The abdominal muscle hypoplasia is thought to be a result of large kidneys compression the developing abdominal musculature during a critical phase of fetal development. Thus, Potter syndrome and prune-belly syndrome may coexist when nonfunctioning large kidneys result in oligohydramnios. A teratogenic role of cytomegalovirus inclusion disease and other viruses is possible in the pathogenesis of these syndromes.

Early onset group B streptococcal disease: clinical, roentgenographic, and pathologic features.

Thirty-one neonates with early onset of serious group B streptococcal infections were observed in a four-year period. The mortality was 52%. Premature infants with clinical signs of respiratory distress syndrome were at highest risk of death; clinical signs of RDS were typical until apnea, shock, respiratory failure, and worsening of the radiographic pattern unexpectedly intervened. Pathologic material from infants with radiographic evidence either of RDS or of pneumonia showed both typical hyaline membrane disease and pneumonia in most instances. Factors which may be helpful in recognizing premature infants at risk for GBS disease in the much larger group of premature infants with uncomplicated RDS include: history of artificial, premature, or prolonged rupture of membranes; localized pulmonary infiltrates on chest roentgenogram; low absolute neutrophil count; and an unusually rapid progression of RDS.

Congenital syphilis after maternal treatment with erythromycin.

A case is reported in which erythromycin was used successfully to treat maternal syphilis but failed to adequately treat the fetus. This report and similar studies suggest that oral erythromycin is not a reasonable alternative drug for the treatment of lues in the penicillin-allergic gravid female.

Decreased colonization of newborn infants with Staphylococcus aureus 80/81: Cincinnati General Hospital, 1960-1972.

The changing pattern of colonization of newborn infants with Staphylococcus aureus was studied by examination of 25,662 nasal and umbilical cultures obtained at weekly intervals from 9,216 infants during 1960-1972. The frequency of colonization of infants in the newborn nursery with S. aureus 80/81 decreased significantly during 1963-1965 and has remained low since that time. This change in colonization was unrelated to the use of hexacholorophene for bathing infants or to changes in sensitivity to the commonly used systemic antibiotics, penicillin and kanamycin. A similar decrease occurred with S. aureus lysed by the group 2 phages, but this decrease rebounded to the earlier level after cessation of hexacholorphene use.