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  • Intestinal perforation  (1)
  • Key words Hereditary spherocytosis  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Monatsschrift Kinderheilkunde 146 (1998), S. 26-29 
    ISSN: 1433-0474
    Keywords: Schlüsselwörter Frühgeborene ; Mukormykose ; Nekrotisierende Enterokolitis ; Darmperforation ; Amphotericin B ; Key words Preterm ; Mucormycosis ; Necrotizing enterocolitis ; Intestinal perforation ; Amphotericin B
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary Gastrointestinal mucormycosis is rare and occurs predominantly in the immunocompromised patient. Earlier case reports on affected preterms described a perforation of the stomach or of the bowel or the patients had signs of necrotizing enterocolitis. We report on a premature infant of 24 weeks of gestation with a bowel perforation. A mucormycosis of the intestine was proven by culture and by histological examination. There was no pneumatosis intestinalis, the bowel perforation happened very early and the small bowel showed a reduced perfusion. These points could allow a differentiation from a typical necrotizing enterocolitis. This is of importance, since a very early diagnosis and a rapid beginning of treatment (surgical extirpation, Amphotericin B) may improve the bad prognosis of a mucormycosis.
    Notes: Zusammenfassung Die gastrointestinale Mukormykose ist ein seltenes Krankheitsbild. Betroffene Frühgeborene fallen durch eine Perforation im Magen-Darm-Trakt oder eine nekrotisierende Enterokolitis auf. Wir stellen ein Frühgeborenes der 24. SSW mit einer Darmperforation vor, bei dem eine Mukormykose des Darms sowohl durch die Kultur als auch im histologischen Präparat nachgewiesen wurde. Im Gegensatz zur „klassischen” nekrotisierenden Enterokolitis lag keine Pneumatosis intestinalis vor, es kam sehr früh zu einer Darmperforation, und der Dünndarm zeigte eine ausgeprägte Minderperfusion. Diese Punkte könnten die Differenzierung zwischen gastrointestinaler Mukormykose und typischer nekrotisierender Enterokolitis erleichtern, was von Bedeutung ist, da nur die frühzeitige Diagnosestellung einen raschen Therapiebeginn (chirurgische Sanierung, Amphotericin B) und damit eine Verbesserung der schlechten Prognose ermöglicht.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-0584
    Keywords: Key words Hereditary spherocytosis ; Postsplenectomy ; Sepsis ; Overwhelming postsplenectomy infections ; Pneumococci
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Very late sepsis in splenectomized patients with hereditary spherocytosis has been seen rarely up to now; the frequency and the immunodeficiency causing it are largely unknown. Within the past 7 years we have learned of four cases of sepsis or meningitis (three fatal) in adult patients with hereditary spherocytosis who had been splenectomized years earlier. The estimated frequency of very late postsplenectomy infections is 0.69 cases of sepsis or meningitis in 1000 patient-years (0.46 deaths in 1000 patient-years). Pneumococci were proven in two patients. The surviving patient showed low antibody titers against pneumococcal serotypes even after pneumococcal meningitis and subsequent vaccination. There have been several reports of an insufficient response to pneumococcal vaccination in patients with severe infections. We recommend determination of pneumococcal antibody titers after immunization in every splenectomized patient: Nonresponders to vaccination may be at high risk for overwhelming postsplenectomy infection. Our data demonstrate that there is a lifelong risk for severe postsplenectomy infections and therefore the lasting need for immediate antibiotic therapy in any case with sudden onset of high fever.
    Type of Medium: Electronic Resource
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