Biomedical subjects
Publications and source records attributed to Andrew J Daley.
Maternal and neonatal infection with Haemophilus parainfluenzae is an unusual but potentially life-threatening occurrence. We present a case of H. parainfluenzae complicating pregnancy in the second trimester. Predisposing factors for infection with Haemophilus species and Australasian data on invasive neonatal Haemophilus infections are presented.
MR findings from six newborns with Escherichia coli (E. coli) meningitis are reported. Five of the six infants were infected with the K1 strain. All the infants displayed significant white matter injury on MR imaging. E. coli remains a serious cause of meningitis and MR imaging in this case series provides additional important information highlighting the vulnerability of the cerebral white matter in this condition in the newborn infant.
BACKGROUND: Intrapartum antibiotics have reduced the incidence of neonatal early onset (EO) group B streptococcal (GBS) disease. Some surveillance data suggest that this success may be at the cost of increasing rates of non-GBS infection, especially in premature neonates. OBJECTIVE: To examine rates of EOGBS infection and EO Escherichia coli neonatal sepsis in Australasia. METHODOLOGY: Analysis of trends in EO (<48 h age) GBS and E. coli sepsis from longitudinal prospective surveillance data collected from representative tertiary obstetric hospitals in each state of Australia and selected centers in New Zealand during a 10-year period from 1992 through 2001. Statistical analysis used Poisson regression. RESULTS: 206 GBS and 96 E. coli cases occurred in 298,319 live births during the study period. The EOGBS sepsis rate fell from a peak of 1.43/1000 live births in 1993 to 0.25/1000 in 2001 (P < 0.001). The overall EO E. coli sepsis rate was 0.32/1000. In babies with birth weight <1500 g, it was 6.20/1000. There was an overall trend to decreasing EO E. coli sepsis (P = 0.07), and there was no significant change in E. coli sepsis in babies <1500 g (P = 0.60). Sixty-nine percent of E. coli cases occurred in the <1500 g cohort; the case fatality rate in this group was 50%. The overall case fatality rate from E. coli sepsis was 36%, and this rate remained stable during the study period (P = 0.47). CONCLUSIONS: The increasing use of intrapartum antibiotics produced a steady decline in EOGBS disease in Australasia. There was also a trend to decreasing EO E. coli sepsis in all babies, and the rate in very low birth weight infants remained stable.
BACKGROUND: Despite significant advances in the prevention and management of Neisseria meningitidis infection, invasive meningococcal disease continues to occur with significant morbidity and mortality. OBJECTIVE: This article aims to provide an overview of the aetiology, pathogenesis, transmission, epidemiology, clinical presentation, diagnosis, treatment and prevention of meningococcal disease. DISCUSSION: Neisseria meningitidis is now the commonest cause of meningitis and is a significant cause of septicaemia, particularly in children and young adults. The initial diagnosis may be difficult but early recognition and treatment is essential. Transmission occurs during close contact and prophylaxis is important to prevent invasive disease in contacts. The conjugate meningococcal C vaccine has recently been funded for all children aged 1-19 years in Australia.
Involvement of the gastrointestinal tract in neonates with congenital herpes simplex virus (HSV) infection is rarely described. We report a case of a newborn with disseminated HSV infection associated with profuse hematochezia and late sigmoid colon perforation. Histologic examination showed patchy areas of ulceration with multinucleated giant cells and HSV nucleic acid was detected by polymerase chain reaction in colonic tissue. No clinically apparent episodes of recurrent colitis occurred in the first year of life.
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