RESUMO
Laryngeal cyst is a rare but generally benign lesion in the larynx. It may cause stridor and life-threatening airway obstruction in early infancy. We report the case of a neonate who developed respiratory distress 24h after birth in relation with materno-fetal infection. Airway obstruction was then suspected because of stridor. A laryngeal mass was discovered at the time of intubation. The infant experienced a nosocomial infection and died on day 14 of life before any surgical treatment. Autopsy concluded in an epiglottic congenital laryngeal cyst.
Assuntos
Cistos/congênito , Doenças da Laringe/congênito , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Sons Respiratórios/etiologia , Obstrução das Vias Respiratórias/congênito , Obstrução das Vias Respiratórias/diagnóstico , Obstrução das Vias Respiratórias/patologia , Infecção Hospitalar/patologia , Cistos/diagnóstico , Cistos/patologia , Evolução Fatal , Humanos , Recém-Nascido , Infecções por Klebsiella/diagnóstico , Infecções por Klebsiella/patologia , Klebsiella pneumoniae , Doenças da Laringe/diagnóstico , Doenças da Laringe/patologia , Masculino , Síndrome do Desconforto Respiratório do Recém-Nascido/patologiaRESUMO
Congenital pulmonary lymphangiectasis (CPL) is a rare condition in neonates characterized by abnormal dilatation of the lymphatics draining the interstitial and subpleural spaces of the lungs. Diagnosis is difficult in the neonatal period because respiratory features and radiological findings are not specific of the disease. Definitive diagnosis of CPL can be made only by pathologic examinations. We report a case of a male near-term neonate presenting with severe respiratory distress at birth. The initial chest X-ray showed frosted glass-like infiltrates with air bronchogram suggesting a maternofetal infection or respiratory distress syndrome. The infant required mechanical ventilation and chest tube insertion for right then bilateral pneumothorax. The child died 15 days later in spite of optimal high-frequency ventilation, bilateral pneumothorax drainage, and hemodynamic support. Autopsy revealed features consistent with the diagnosis of CPL. Although CPL is very rare, we should be aware that it is a possible cause of severe unexplained respiratory distress in neonates.
Assuntos
Pneumopatias/congênito , Linfangiectasia/congênito , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Broncografia , Tubos Torácicos , Diagnóstico Diferencial , Evolução Fatal , Humanos , Recém-Nascido , Terapia Intensiva Neonatal , Pulmão/patologia , Pneumopatias/complicações , Pneumopatias/diagnóstico , Pneumopatias/patologia , Pneumopatias/terapia , Linfangiectasia/complicações , Linfangiectasia/diagnóstico , Linfangiectasia/patologia , Linfangiectasia/terapia , Vasos Linfáticos/patologia , Masculino , Respiração Artificial , Síndrome do Desconforto Respiratório do Recém-Nascido/diagnóstico , Síndrome do Desconforto Respiratório do Recém-Nascido/patologia , Síndrome do Desconforto Respiratório do Recém-Nascido/terapiaRESUMO
Arterial thromboses are rare in newborns, mostly caused by arterial catheters. Neonatal arterial thrombosis occurring in other contexts is much rare. We report arterial thrombosis, not caused by catheterisation in 4 neonates hospitalised in the neonatology department of the Farhat Hached de Sousse hospital in Tunisia. The diagnosis of arterial thrombosis was made based on signs of ischemia in 2 patients affected by thrombosis of the iliac arteries. The symptoms were less clear: anuria associated with arterial high blood pressure in 1 patient affected by thrombosis of the abdominal aorta and by anuria with melena in a newborn with aortic and mesenteric thrombosis. Diagnosis was confirmed by Doppler sonography in 3 patients and based on autopsy data in 1 patient. A delay to consultation was noted in 3 patients, whose outcome was fatal. The progression was favourable after thrombolysis and anticoagulation using heparin in 1 patient with major aortic thrombosis. A review of the literature on the epidemiological, clinical, therapeutic and outcome data of the arterial thrombosis in the newborn child is provided.
Assuntos
Anuria/etiologia , Aorta Abdominal , Doenças da Aorta/diagnóstico , Artéria Ilíaca , Isquemia/etiologia , Melena/etiologia , Artérias Mesentéricas , Oclusão Vascular Mesentérica/diagnóstico , Trombose/diagnóstico , Angiografia , Anticoagulantes/uso terapêutico , Doenças da Aorta/tratamento farmacológico , Diagnóstico Diferencial , Evolução Fatal , Feminino , Heparina/uso terapêutico , Humanos , Recém-Nascido , Intestino Delgado/irrigação sanguínea , Isquemia/tratamento farmacológico , Rim/irrigação sanguínea , Perna (Membro)/irrigação sanguínea , Masculino , Oclusão Vascular Mesentérica/tratamento farmacológico , Estreptoquinase/uso terapêutico , Terapia Trombolítica , Trombose/tratamento farmacológico , Ultrassonografia , Ultrassonografia DopplerRESUMO
Ectopic intrathoracic kidney is a very rare congenital anomaly, which is often asymptomatic and discovered incidentally on chest radiography. Diagnosis of this ectopia in the neonatal period is extremely rare. We report the case of a female infant admitted for mild respiratory distress at birth in relation with maternofetal infection in whom a right posterior opacity on chest x-ray was diagnosed as intrathoracic kidney by sonography and chest CT scan. Diaphragmatic hernia could not be confirmed at this stage. At 2 months, the presence of air blebs on chest x-ray performed for viral bronchiolitis confirmed an associated right Bochdalek hernia. The infant, although asymptomatic, underwent surgery. The intrathoracic kidney was reduced into the abdominal cavity at the time of surgery. The postoperative course was uneventful and renal function was normal.
Assuntos
Coristoma/diagnóstico por imagem , Hérnias Diafragmáticas Congênitas , Achados Incidentais , Pneumopatias/diagnóstico por imagem , Coristoma/cirurgia , Diagnóstico Diferencial , Feminino , Hérnia Diafragmática/diagnóstico por imagem , Hérnia Diafragmática/cirurgia , Humanos , Recém-Nascido , Rim , Pneumopatias/cirurgia , Radiografia , Procedimentos Cirúrgicos Torácicos , Resultado do Tratamento , UltrassonografiaRESUMO
Incontinentia pigmenti (IP) is a rare affection inherited as X-linked dominant disease. It is usually lethal in male infants. IP can affect ectodermal tissues such as the skin, teeth, eyes, bones, and the central nervous system. Skin lesions occur mostly during the neonatal period and are characterized by a classic progression in 4 stages leading to hyperpigmentation. We report on the case of a female neonate presenting on the 3rd day of life with seizures without obvious cause, in which the diagnosis of IP was made 1 week later when skin lesions appeared.
Assuntos
Incontinência Pigmentar/diagnóstico , Incontinência Pigmentar/genética , Convulsões/genética , Pele/patologia , Anormalidades Dentárias/patologia , Anticonvulsivantes/uso terapêutico , Consanguinidade , Diagnóstico Diferencial , Feminino , Humanos , Incontinência Pigmentar/patologia , Recém-Nascido , Fenobarbital/uso terapêutico , Fatores de Risco , Convulsões/tratamento farmacológico , Resultado do TratamentoRESUMO
UNLABELLED: Congenital cutaneous candidiasis presenting at birth is very uncommon and is due to intra-uterine infection. The systemic form has to be considered when cutaneous signs are associated with sepsis symptoms. CASE REPORT: A female infant was born by vaginal delivery at 35 weeks' gestation to a mother whose pregnancy had been complicated by urinary tract infection treated 3 days before delivery. The infant was admitted because of respiratory distress. Clinical features consisted of respiratory retraction signs associated with hepatomegaly and rash on the trunk. The white blood cell (WBC) count was 50 × 10(9)/L and C-reactive protein was negative. Maternofetal bacterial infection was suspected and intravenous antibiotics were prescribed. Over the next 6h, macules appeared on the trunk, back, and limbs, which changed after 24h into papulovesicular lesions over the trunk, back, limbs, palms, and scalp. Congenital candidiasis was suspected, confirmed by cultures from vesicle swabs and maternal vaginal discharge. The systemic form was considered because of respiratory distress requiring oxygen therapy for 4 days, hepatomegaly, elevated WBC count, and chest X-ray infiltrates. The infant was started on intravenous systemic antifungal therapy (fluconazole, 6 mg/day). Treatment was continued for 3 weeks. The rash resolved by desquamation after about 1 week and hepatomegaly disappeared. The infant remained well at follow-up.