The silent ductus arteriosus

Preterm infants at risk of developing a patent ductus arteriosus were followed sequentially by physical examination, echocardiographic determinations of the LA/AO ratio, and chest roentgenograms. The results show that a significant number of infants who have no clinical signs or symptoms of a PDA have large left-to-right shunts. The presence of this shunt was suggested by acute increase in left atrial size by ECHO determination and confirmed by retrograde single-film aortography. Clinical signs and symptoms often developed several days after documentation of the left-to-right shunt.     

Treatment of ampicillin-resistant Haemophilus influenzae in soft tissue infections with high doses of ampicillin.

Six soft tissue infections (three epiglottitis, one cellulitis, one pneumonia, and one arthritis) with ampicillin-resistant Haemophilus influenzae were treated initially with high doses of ampicillin (200 to 400 mg/kg/day intravenously) alone and had good clinical responses. All had documented bacteremia with H. influenzae. One child was treated only with ampicillin; treatment in the remainder was changed to oral therapy with other antibiotics to facilitate discharge. There was no recurrence of disease. Disc diffusion studies done on clinical isolates of both resistant and sensitive organisms indicate a break point at which the resistant organism shows progressive sensitivity to increasingly higher concentrations of ampicillin.