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Query: UMLS:C0243026 (sepsis)
 52,417 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The Authors report a case of two pre-term monocorial twins affected by HSV-1 infection (Herpes Simplex Virus type 1), with generalized sepsis and involvement of the central nervous system (CNS), born by mother with primary infection who presented a typical vesicular eruption a week before delivery. As the HSV-1 was a disseminated type and the CNS was involved in both the twins, the diagnosis was based on clinical and laboratory findings (specific IgM and IgG) and on the use of Delpech-Lichtblau antibody liquoral index, a significant results both in the first and the second twin. Intensive care and early specific treatment with Acyclovir allowed a slow but progressive improvement of the twins' clinical picture. The antibody liquoral index may therapy of the viral sepsis cases involving the CNS, more than the cultural or antigen isolation of the treated virus.
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PMID:[Herpes simplex virus infection in pregnancy: epidemiologic, diagnostic and therapeutic data. An unusual case of HSV-1 in monozygotic twins]. 128 30

A case of neonatal Herpes simplex infection is being described, which was diagnosed clinically as well as serologically. It concerns a child, which was born after 35 weeks of gestation. Two days after the delivery the mother showed typically efflorescences of Herpes simplex infection in the abdominal region. On the fifth day after birth the child showed a vesico-bullous exanthema beginning on the head and spreading out on breast and back. On day 14th a serious sepsis-like pattern of the disease with respiratory insufficiency and encephalitic symptoms could be seen. Treatment with Vidarabinphosphat and Acyclovir-Natrium was without definite success. At the age of five months the child showed a pseudobulbar-paralysis with tetra-spasticity. The cranial computer-tomography demonstrated a distinct hydrocephalus e vacuo and the electroencephalography registered only sporadic brain activity.
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PMID:[Herpes simplex infection in the newborn infant]. 298 61

Varicella causes a mild, self-limiting childhood disease that may reactivate years later as shingles. In immunocompromised patients with altered cell mediated immunity, and rarely in healthy individuals, varicella results in a life-threatening infection. The antiviral drug, acyclovir, substantially reduces the mortality and risk of severe disease in these groups of patients. Early commencement of acyclovir is recommended for children with both varicella and altered cell mediated immunity, newborns during the first 2 weeks of life, preterm infants in the neonatal nursery, and severe varicella or shingles (including ocular zoster) in any patient, as well as during pregnancy. Acyclovir may be considered in children with serious cardiopulmonary disease or chronic skin disorders where varicella may exacerbate the underlying disease or increase the risk of secondary bacterial sepsis. Acyclovir, however, is not recommended for healthy individuals without severe disease, as a prophylactic agent against varicella, for asthmatics receiving aerosolized or low-dose oral steroids and/or as treatment of the post-varicella syndromes. When acyclovir is prescribed it should be given intravenously to those with severe disease, those at risk of dissemination and in children younger than 2 years of age.
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PMID:Acyclovir for the prevention and treatment of varicella zoster in children, adolescents and pregnancy. 882 37

A neonate presenting to the emergency department can present a challenge to even the most experienced clinician. This article has focused on four deceiving and potentially devastating neonatal diseases. 1. Neonatal herpes is a potentially devastating illness without pathognomonic signs or symptoms. Early recognition and therapy can reduce mortality markedly. Although no specific sign or symptom is diagnostic,the diagnosis should be strongly considered in the presence of HSV risk factors, atypical sepsis, unexplained acute hepatitis, or focal seizure activity. Acyclovir therapy should be initiated before viral dissemination or significant CNS replication occurs. 2. Pertussis is a disease in which infants are at greatest risk of death or severe complication. Neonatal pertussis often presents in an atypical manner, lacking the classic signs and symptoms such as the "whoop."More common signs and symptoms include cough, feeding difficulty,low-grade fever, emesis, increasing respiratory distress, apnea, cyanosis,and seizures. Management should include hospitalization, supportive care, and antibiotics. 3. Congenital heart defects, particularly ductal-dependent lesions, may have an initial asymptomatic period that culminates in a rapidly progressive and fatal course. A neonate with CHD presents with shock refractory to volume resuscitation or pressor support. Resuscitative efforts are ineffective unless PGE, is administered. 4. Inborn errors of metabolism often are unsuspected because of their protean and heterogeneous nature. Signs and symptoms are subtle,are nonspecific, and often mimic other, more common diseases.An elevated index of suspicion, along with application and correct interpretation of a select few laboratory tests, is the key to making a diagnosis. Therapy is relatively straightforward and focused on resuscitation followed by prevention of catabolism and correction of specifically identified abnormalities. Although these disorders are relatively uncommon, prompt diagnosis and therapy can lead to a decrease in morbidity and mortality. The key is to maintain a high index of suspicion.
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PMID:Unsuspected neonatal killers in emergency medicine. 1547 77

Neonatal Herpes Simplex Virus (HSV) infection is a serious illness with significant mortality and morbidity for disseminated disease. Clinical diagnosis of neonatal HSV infection is often difficult without evidence of HSV exposure, for example, absence of a rash or the presence of non-specified manifestations in an infant. Early recognition and treatment with high-dose Acyclovir may dramatically improve the short and long-term outcomes. We describe an infant with disseminated disease due to HSV-1 infection, who first presented clinical and radiologic features of pneumonia. The diagnosis was performed post-mortem by Real-Time Polymerase Chain Reaction (PCR) analysis of blood, cerebrospinal fluid and pleural liquid of the infant. Tissue PCR revealed a disseminated HSV-1 infection, with a high viral load detected in liver, lungs, brain, heart, striated muscle, kidneys, and thymus tissues. This case report highlights the need for neonatologists to raise awareness about the different clinical manifestations of disseminated neonatal HSV infection. HSV infections should be prominent in the differential diagnosis of an infant under four weeks of age with fever, pneumonia, unexplained seizures or sepsis-like disease, particularly if unresponsive to antibiotics. Early initiation of appropriate antiviral therapy for high-risk infants undergoing testing for HSV infection can be essential to prevent significant morbidity and mortality.
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PMID:Herpes Simplex Virus 1 infection: misleading findings in an infant with disseminated disease. 2391 73