RESUMEN
Subcutaneous fat necrosis is an inflammatory disorder of adipose tissue. Although patients need long-term follow-up to prevent hypercalcemia, the prognosis is generally favorable. We herein present a case of a newborn who developed subcutaneous fat necrosis-related hypercalcemia after hypothermia treatment for hypoxic ischemic encephalopathy. Widespread use of hypothermia treatment for hypoxic ischemic encephalopathy in the neonatal intensive care unit may increase the risk of developing subcutaneous fat necrosis and subsequently hypercalcemia. Great care should be taken to recognize skin findings early in newborns receiving hypothermia treatment, and those diagnosed with subcutaneous fat necrosis require close follow-up because they are at risk for developing hypercalcemia.
Asunto(s)
Necrosis Grasa/patología , Hipercalcemia/etiología , Hipotermia Inducida/efectos adversos , Hipoxia-Isquemia Encefálica/terapia , Grasa Subcutánea/patología , Biopsia con Aguja , Quimioterapia Combinada , Necrosis Grasa/complicaciones , Necrosis Grasa/tratamiento farmacológico , Femenino , Estudios de Seguimiento , Humanos , Hipercalcemia/tratamiento farmacológico , Hipercalcemia/fisiopatología , Hipotermia Inducida/métodos , Hipoxia-Isquemia Encefálica/diagnóstico , Inmunohistoquímica , Recién Nacido , Unidades de Cuidado Intensivo Neonatal , Medición de Riesgo , Índice de Severidad de la Enfermedad , Resultado del TratamientoRESUMEN
Listeria monocytogenes, although an uncommon cause of illness in the general population, is an important pathogen in pregnants, neonates, elderly and immunocompromised patients. Neonatal listeriosis is classified as early (< 5 days) and late (? 5 days) according to the onset of the symptoms and findings of the infection. The most encountered serotypes in early neonatal listeriosis are 1a and 1b, while serotype 4a is more prevalent in the late form. In this report, a neonatal L.monocytogenes meningitis case developed in a female infant born after 36 weeks of gestation from a 29 years old mother, was presented. The newborn was hospitalized in intensive care unit because of low birth weight (1740 g) and prematurity. Due to the worsening of her general condition (feedings difficulty, tachypnea, high fever and bulging fontanel) on the 11th day, blood and cerebrospinal fluid (CSF) cultures were done. CSF culture yielded catalase positive, oxidase negative, gram-positive bacilli on the 4th day of cultivation. The isolate was identified as Listeria monocytogenes and found susceptible to all tested antibiotics (erythromycin, gentamicin, penicillin, trimethoprim sulphamethoxazole, vancomycin, teicoplanin) by automated identification and antibiogram system (VITEC 2, bioMérieux, France). The empirical treatment initiated with vancomycin and meropenem was changed to ampicillin and gentamicin and clinical and microbiological response was obtained. The isolate was serotyped as type 1/2b. No data related to maternal infection or environmental contamination were obtained from the studies investigating the origin of infection. There have been no reported cases of neonatal Listeria meningitis from Turkey in the avaliable literature. This was the first case of neonatal Listeria meningitis in our country and it was presented to withdraw attention to L.monocytogenes serotype 1/2b which was a rare cause of late onset neonatal listeriosis.