[Extradural hematoma of a newborn infant. Rare complication of forceps delivery].
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Biomedical subjects
Publications and source records attributed to J B Gouyon.
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A heparin-induced case of thrombocytopenia occurring in an adolescent is reported. Its physiopathology and treatment are discussed. Complications are not only bleeding, but also arterial or venous thrombosis. Usually, stopping of heparin therapy is necessary, but sometimes the treatment should be followed with low molecular weight heparin.
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In a prospective study, 23 severe staphylococcal infections (9 meningitis, 10 bone and joint infections, 3 septicaemia, 1 superinfection of a congenital varicella) were treated with cefotaxime and fosfomycin in combination. There was a synergistic effect of the combination for 14 of the 17 strains tested. Three hours after the end of the infusion, mean CSF concentrations of cefotaxime and fosfomycin were respectively at day 2 3.2 mg/l and 31.4 mg/l, at day 4 2.9 mg/l and 33.9 mg/l. All the patients with meningitis or acute bone and joint infections recovered satisfactorily without relapses. Two superinfections were observed (one systemic candidosis and one septicaemia due to Pseudomonas aeruginosa). Clinical tolerance was good and treatment was discontinued for side effects in only three patients.
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The authors report the case of dizygotic twins suffering from transitory neonatal hypoparathyroidy and leading to the diagnosis of maternal hyperparathyroidy. The differences of clinical and biological symptomatology between these twins suggest individual variations in response to phosphocalcic disorders of the mother. A review of literature find 31 other cases. This study emphasize the aggravation by the mild hypomagnesemia frequently associated, the usual severity of initial clinical symptomatology in contrast with a good neurologic outcome, the diagnosis of maternal hyperparathyroidy.
Two new cases of 69 XXY triploidy in live-born neonates are reported. As in 40 others cases of literature observed after 24 weeks of gestation, this chromosome abnormality was lethal. The clinical features are: a large posterior fontanelle, low set ears, syndactylies of hands and feet, and genital abnormalities in the presence of a 69 XXY karyotype. The first patient present a macrocytosis of red blood cells. Macrocytosis, large polymorphonuclear leukocytes and platelets can evoke the diagnosis of triploidy in a malformed newborn.
On the occasion of the reports of 6 cases, the authors summarize the clinical and electro-encephalographic features of apneic seizures, the value of polygraphic recordings to detect them, their poor prognosis and the contra-indication of xanthine treatment.
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Hydranencephaly is an uncommon finding in congenital toxoplasmosis. The authors report a new case and emphasize the toxoplasmic etiology of this malformation, the possibility of normal neurologic examination at birth, and the usefulness of cranial transillumination whenever congenital toxoplasmosis is suspected in a neonate.
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