Clinical Significance of Human Metapneumovirus in Refractory Status Epilepticus and Encephalitis: Case Report and Review of the Literature

Encephalitis is a complex neurological disease that is associated with significant morbidity and mortality, and the etiology of the disease is often not identified. Human metapneumovirus (hMPV) is a common cause of upper and lower respiratory tract infections in children. Few reports are available showing possible involvement of hMPV in development of neurologic complications. Here, we describe an infant, the youngest case in literature, with refractory status epilepticus and severe encephalitis in whom hMPV was detected in respiratory samples and review diagnostic workup of patient with encephalitis

Bacteremia due to Achromobacter xylosoxidans in neonates: clinical features and outcome

OBJECTIVE: We report an outbreak of Achromobacter xylosoxidans at a neonatal intensive care unit. We aimed to present clinical, laboratory and treatment data of the patients. Materials and METHODS: All consecutive episodes of bacteremia due to A. xylosoxidans at our neonatal intensive care unit, beginning with the index case detected at November 2009 until cessation of the outbreak in April 2010, were evaluated retrospectively. RESULTS: Thirty-four episodes of bacteremia occurred in 22 neonates during a 6-month period. Among the affected, 90% were preterm newborns with gestational age of 32 weeks or less and 60% had birth weight of 1000 g or less. Endotracheal intubation, intravenous catheter use, total parenteral nutrition and prolonged antibiotic therapy were the predisposing conditions. Presenting features were abdominal distention, thrombocytopenia and neutropenia. The mortality rate was 13.6% and the majority of isolates were susceptible to piperacillin-tazobactam, carbapenems and trimethoprim-sulfametoxazole, and resistant to gentamycin. More than half were breakthrough infections. Despite intensive efforts to control the outbreak by standard methods of hand hygiene, patient screening and isolation, containment could be achieved only after the neonatal intensive care unit was relocated. The investigation was not able to single out the source of the outbreak. CONCLUSION: A. xylosoxidans has the potential to cause serious infections in premature babies. More studies are needed to determine the importance of different sources of infection in hospital units

The effectiveness of cerebellar lesions on neurocognitive functions in children with neurofibromatosis Type 1: Diffusion tensor imaging features

In children with Neurofibromatosis type 1 (NF1), hamartomatous lesions called FASI (focal areas of signal intensity) on brain MRI are common. The relationship between neurocognitive functions and the presence of cerebellar FASI in NF1 children is a controversial issue. Our aim in this study is to investigate whether there is a difference in fractional anisotropy (FA) and mean diffusivity (MD) values in children with NF1 with and without cerebellum FASI, and to analyze its effect on neurocognitive functions. Twenty-seven patients children were assessed using Diffusion Tensor Imaging (DTI) and MRI. According to MRI features, we classified children with NF1 as group 1 with FASI (n=14) in the cerebellum, group 2 without FASI (n=13). The WISC-R scale (a revised form of the Wechsler intelligence scale for children) was used to analyze cognitive functions. MD and FA values were measured from cerebellar FASI and white matter. The relationship between neurocognitive function test scores and FA and MD values was investigated. There was a significant difference between group 1 and group 2 in terms of MD and FA values of the cerebellum. Verbal and performance test scores were lower in group 1 and group 2. The MD values obtained from the cerebellum were positively correlated with the full-scale intelligence quotient (IQ), Verbal IQ, and Performance IQ. There was a significant difference between group 1 and group 2 in terms of information, vocabulary, digit span, picture arrangement. DTI changes in the cerebellum are associated with demyelination and loss of axonal integrity in the white matter pathways responsible for some neurocognitive functions. We think that the presence of cerebellar FASI in children with NF1 does not contribute to the severity of neurocognitive impairment. [Med-Science 2021; 10(2.000): 506-10