Horizontal transmission of novel H1N1/09 influenza virus in a newborn: Myth or fact?

Horizontal transmission of H1N1/09 virus infection is very common however; transmission through this route has not been reported in newborns. To our knowledge, this is the first case report of newborn who acquired infection of novel H1N1/09 virus horizontally through asymptomatic family members or hospital staff during epidemic period in Kolkata, India. Baby recovered without antiviral therapy but received antibiotic for bacterial co-infection.     

NEONATAL PURPURA FULMINANS DUE TO HOMOZYGOUS PROTEIN C DEFICIENCY

Severe and recurrent purpura fulminans developed in a Turkish boy at 1 week of age. Initial coagulation studies performed were compatible with disseminated intravascular coagulation. Subsequent investigations showed that the patient had homozygous and his healthy parents had heterozygous protein C deficiency. The episodes of purpura fulminans were controlled by infusions of fresh frozen plasma and heparinization. Oral anticoagulant therapy was given in the symptom-free period.     

Unusual cause of neonatal cyanosis

We present a case of a full-term female neonate who presented at 6 h of age with severe cyanosis and was partially responsive to oxygen supplementation. An echocardiogram showed an isolated congenital severe tricuspid valve insufficiency due to rupture of the papillary muscle of the anterior tricuspid valve leaflet. Magnesium sulfate was infused to lower the pulmonary resistance and thus enhancing the antegrade pulmonary blood flow. Ductal patency was secured by prostaglandin infusion thus providing an additional pulmonary blood flow through the ductus arteriosus.The above measures were adequate to stabilize the patient with no further deterioration or the need for other supportive measures such as Nitric Oxide therapy or extracorporeal membrane oxygenation (ECMO). Therefore, early diagnosis and adequate measures to improve the pulmonary blood flow are mandatory, important pre-operative measures in the management of these patients.     

超声弹性成像技术在新生儿缺氧缺血性脑病中的应用

目的:探讨超声弹性成像技术(ARFI)在新生儿缺氧缺血性脑病中的临床应用价值。方法:新生儿共159例,根据胎龄分为早产儿(<37周)、足月儿(≥37周);早产儿共93例,分为缺血性脑病组(HIE,n=20)和非HIE组(n=73)。足月儿共66例,亦分为HIE组(n=16)和非HIE(n=50)。各组新生儿均行常规颅脑二维超声及彩色多普勒检查,并于ARFI模式下测量颅脑双侧顶叶、丘脑的声触诊组织量化(VTQ)值,分析四组间检测结果的差异。结果:(1)各组丘脑和顶叶VTQ值稳定,丘脑VTQ均值(1.60m/s)大于顶叶均值(1.30m/s);(2)足月HIE组左侧丘脑VTQ值小于足月非HIE组,早产非HIE组左侧顶叶VTQ值小于足月非HIE组,差异均具有统计学意义(P<0.05);(3)足月非HIE组中B超异常新生儿左侧顶叶VTQ值小于B超正常者,早产非HIE组中B超异常新生儿左侧丘脑VTQ值小于B超正常者,差异均具有统计学意义(P<0.05)。结论:ARFI技术应用于新生儿颅脑实现了真正意义上的声触诊,有望成为新生儿特别是早产儿脑损伤早期诊断手段之一。