Acquired eventration of the diaphragm: a complication of chest tube placement in neonatal pneumothorax.
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Biomedical subjects
Publications and source records attributed to E R Alden.
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A new micro-heelstick blood culture technique was evaluated in 40 neonates who were believed to be clinically septic. Heelstick cultures were positive in 11 and peripheral venous cultures were positive in eight. All eight venous cultures had positive heelstick cultures. Heelstick blood cultures seem to be at least as sensitive as venous cultures.
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The symptomatology and sequelae of symptomatic system arteriovenous (A-V) malformations in children less than 6 months old make an early diagnosis possible and early treatment mandatory. A group of 156 infants with systemic A-V malformations involving the CNS (81 infants), liver (61 infants), and lungs (14 infants) were studied to compare symptoms, diagnosis, treatment, and outcome. Congestive heart failure was present in 67% of the patients with CNS A-V malformations. Mortality among the patients with CNS A-V fistulas was 64%. Of those patients with hepatic A-V malformations 67% had abdominal masses, 48% congestive heart failure, and 55% died. Pulmonary A-V malformations presented with congestive heart failure 57%, cyanosis 43%, and resulted in a 43% mortality. Early combined medical and surgical therapy offered the best chance for a successful outcome.
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Four patients, with an additional seven from the literature, had meningitis following a lumbar puncture (LP) that disclosed normal cerebrospinal fluid (CSF). Animal studies demonstrate that perforation of the meninges in the presence of bacteremia enhances the development of meningitis. Simultaneous blood culture should be obtained with all LPs. Regardless of the results of the initial LP, a second CSF examination is recommended in any patient whose clinical condition is deteriorating. If the initial blood culture is positive, a second LP should be strongly considered in all newborn and very young infants.
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