RESUMEN
El virus de la varicela se caracteriza por su neurotropismo y su capacidad de reinfección. La prevalencia en las mujeres embarazadas es de alrededor de 0,7/1.000, pero el riesgo de embriopatía es del 2%. Los efectos en el feto son mortales en las primeras 20 semanas de gestación. Presentamos el caso de un neonato con hipotonía, dificultad respiratoria y lesiones cicatriciales metaméricas. La sospecha de infección materna en la semana 15 se confirmó con la realización de una serología en la madre y el neonato. La reacción en cadena de la polimerasa para la varicela fue positiva en el líquido cefalorraquídeo del paciente. Destacaba una mala tolerancia oral y la presencia de neumonías por aspiración. La tomografía computarizada mostró una dilatación esofágica. La manometría puso de manifiesto un hipoperistaltismo esofágico, y la biopsia, signos de inflamación en los plexos mientéricos. Se constataron calcificaciones hepáticas, cerebrales y coriorretinitis. La hipomotilidad esofágica secundaria a la extensa viremia es la principal manifestación neurológica en este caso, y condiciona el pronóstico (AU)
The chickenpox virus is known for its neurotropism and its abil ity to reinfection. Prevalence in the pregnant woman is of 0.7 per 1,000 but the risk of embryopathy is of 2%. The effects on the fetus can be lethal during the first 20 weeks of pregnancy. We present a newborn baby with hypotonia, difficulty breathing, and skin scarring with metameric distribution. Suspicion of maternal infection at the 15th week of pregnancy is verified with positive serology in mother and newborn baby. The polymerase chain reaction for chickenpox is positive in the cerebrospinal fluid of the patient. A poor oral tolerance and aspiration pneumoniast and out. The CT shows an esophageal dilatation. The objective manometry shows hypoperistatic esophagus and the biopsy shows signs of myenteric plexus inflammation. Chorioretintis, liver and brain calcifications were also evident. Esophageal hypomotility secondary to an extensive viremia is the main neurological manifestation in our case and determines the prognosis (AU)
Asunto(s)
Humanos , Masculino , Recién Nacido , Varicela/congénito , Herpesvirus Humano 3/patogenicidad , Dilatación Patológica/etiología , Esofagitis/etiología , Enfermedades Fetales/diagnósticoRESUMEN
Review of 208 patients with bacterial meningitis, admitted from march 1, 1971 to march 1, 1976. Incidence peak was found in Winter (december to march). Etiologically N. meningitiditis, 39, 9%, was the mainly predominate germ. In 49% of the patients C.S.F. cultures were negative, significantly influenced by the previous treatment with antibiotics (P less than 0.001). Cure was obtained in 86.5% Convulsions, 12%, were the most frequent complication, followed by subdural effussion, 3.8%, and arthritis, 2.4%. Twenty patients died, 9.6%; fifteen of them with endotoxic shock. Definitive sequelae was present in the 3.8%, mainly hidrocephaly. A comparative study with other series in Spain is performed.
Asunto(s)
Meningitis Meningocócica/epidemiología , Antibacterianos , Infecciones Bacterianas/epidemiología , Femenino , Humanos , Masculino , Meningitis/microbiología , Meningitis Meningocócica/tratamiento farmacológico , España , SupuraciónRESUMEN
Five children with tuberculosis were treated with isoniazid (20 mg./Kg./day) and rifampin (15 mg./Kg./day). After five to twenty seven days of treatment they presented anorexia, vomiting and jaundice. Hepatomegaly was found in two of them. High indirect bilirubin, S.G.O.T. and S.G.P.T. and low prothrombin levels were present in all of them. Eight to thirty one days after withdrawal of rifampin, all patients were well and their laboratory data was normal.
Asunto(s)
Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Isoniazida/efectos adversos , Rifampin/efectos adversos , Tuberculosis/tratamiento farmacológico , Adolescente , Adulto , Niño , Diagnóstico Diferencial , Femenino , Humanos , Isoniazida/uso terapéutico , Masculino , Rifampin/uso terapéutico , Tuberculosis/diagnósticoRESUMEN
Chromosomal identification by a G technique done in three patients with delection of the distal portion of short arms of chromosome 5; led to the consideration of the possibility that the segment responsible of the "cri du chat" syndrome is on the proximal portion of the band 5 p15.
Asunto(s)
Síndrome del Maullido del Gato/diagnóstico , Síndrome del Maullido del Gato/genética , Humanos , Lactante , Cariotipificación , MasculinoRESUMEN
Review of 102 admissions of children (one month to seven years of age) with bacterial meningitis is presented. 46 of the patients (45%) had been treated previously with one or more antibiotics. Previous treatment made culture of CSF negative in a statistically significant (p less than 0.001) number of cases, mainly in meningococcal meningitis. There were no significant differences in the levels of CSF glucose, proteins and WBC's between both groups. A decrease of the percentage PMN/lymphocytes was found in the CSF of the partially treated group. In 7 out of 102 no more than two CSF pathological findings were present. In 5 or 7 CSF cultures were positive. In the other two there were pathological changes in CSF even with correct dosage of previous antibiotics. In 4 patients with positive cultures and little changes in CSF on admission, LP after 48 hours of correct treatment showed an increase in the alterations of CSF. This could mean that previous low dosage antibiotic treatment should not modify CSF findings enough not to make correct diagnosis.