Biomedical subjects
R J Ancona
Publications and source records attributed to R J Ancona.
In utero cerebral hemorrhage in alloimmune thrombocytopenia.
Central nervous system hemorrhage is a well-recognized complication of neonatal alloimmune thrombocytopenia attributed to perinatal trauma from passage through the birth canal. That central nervous system (CNS) hemorrhage can occur in utero is not as well recognized, and congenital CNS lesions have only circumstantially been linked to thrombocytopenia. We report two cases of intrauterine CNS hemorrhage shown to have occurred prenatally, resulting in porencephaly. The second case is unique in that the necropsy finding of a porencephalic cyst arising from an old hemorrhagic site pathologically confirms that the etiology of congenital CNS lesions in alloimmune thrombocytopenia is due to hemorrhage. This second case received close prenatal monitoring and yet died as a result of hemorrhage that was not detected until emergency operative delivery. A review of the literature revealed 10 cases, including two other pairs of siblings, who had CNS damage attributable to intrauterine hemorrhage. These findings indicate that congenital CNS lesions in alloimmune thrombocytopenia are due to intrauterine hemorrhage that careful obstetric and prenatal care may not identify or prevent. This fact should be included when genetic counseling is offered to alloimmunized mothers.
Maternal factors that enhance the acquisition of group-B streptococci by newborn infants.
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Group B streptococcal sepsis with osteomyelitis and arthritis. Its occurrence with acute heart failure.
In a 20-day-old female infant, bacteremia, osteomyelitis, and pyogenic arthritis developed due to infection with group B streptococcus, type Ic. She had an unusual clinical presentation with overwhelming sepsis and acute congestive heart failure.
Experimental vaginal colonization and mother-infant transmission of group B streptococci in rats.
An animal model for group B streptococcal vaginal colonization and neonatal acquisition was developed with albino rats. Intravaginal inoculation of genital isolates of group B streptococci of serotypes Ia, II, and III either once or on 3 successive days resulted in carriage of the organisms for 7 days or longer in 26% of the virgin animals and 43% of the pregnant animals. Throat and perianal cultures of the offspring of pregnant rats revealed that 51% of the rat pups acquired the organisms at some time. Litter exchange studies were done to explore the contributions of environmental and intralitter spread. Significantly more infants born to mothers with positive vaginal cultures acquired the organisms than infants of culture-negative mothers who were suckled by positive adoptive mothers. However, 13% of the offsprinital cultures acquired group B streptococci. This model may be valuable in understanding the dynamics of vaginal carriage and mother-infant transmission of group B streptococci.
Group G streptococcal pneumonia and sepsis in a newborn infant.
A case of neonatal pneumonia and sepsis caused by a group G Streptococcus is described. Clinical and microbiological aspects of group G streptococci are compared with those of group B streptococci.