[Necrotic funisitis].

Abstract

The authors report eighty eight cases of a perticular type of funisitis characterized by perivascular necrosis of Wharton's jelly. The accompanying leucocyte reaction is weak, and sometimes nil, and the inflammatory lesions of the placenta are also moderate, and sometimes absent. The necrosis of the cord is, however, sufficiently pronounced to be visible to the naked eye. The neonate is often--but not always--very premature, but rarely shows clinical signs of infection (only one case in five). It nonetheless presents with hyperleucocytosis from birth, often severely, but this clears up within a few days, even in the absence of antibiotherapy. A very high rate of blood IgM is also often observed in these infants, on the day of birth. Immediate survival and postnatal development often present no problems. The etiology is not known. There are indirect arguments in favor of a rare germ which cannot be visualized by routine techniques, or possibly a virus. But this remains to be proved. Some observers have suggested that it is the fruit of a particular diathesis, with a tissular reaction to a non-infectious aggression by some modification of the amniotic fluid but this too remains to be established.