Basophilic invasion in the neurohypophysis is increased in patients with Alzheimer's disease.
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Kaplan Ron L, Cruz Andrea T, Freedman Stephen B, Smith Kathleen, Freeman Julia, Lane Roni D, Michelson Kenneth A, Marble Richard D, Middelberg Leah K, Bergmann Kelly R, McAneney Constance, Noorbakhsh Kathleen A, Pruitt Christopher, Shah Nipam, Badaki-Makun Oluwakemi, Schnadower David, Thompson Amy D, Blackstone Mercedes M, Abramo Thomas J, Srivastava Geetanjali, Avva Usha, Samuels-Kalow Margaret, Morientes Oihane, Kannikeswaran Nirupama, Chaudhari Pradip P, Strutt Jonathan, Vance Cheryl, Haines Elizabeth, Khanna Kajal, Gerard James, Bajaj Lalit
Аннотация
METHODS: Within the Pediatric Emergency Medicine Collaborative Research Committee, 28 sites reviewed records of infants ≤90 days of age with omphalitis seen in the emergency department from January 1, 2008, to December 31, 2017. Demographic, clinical, laboratory, treatment, and outcome data were summarized.
RESULTS: Among 566 infants (median age 16 days), 537 (95%) were well-appearing, 64 (11%) had fever at home or in the emergency department, and 143 (25%) had reported fussiness or poor feeding. Blood, urine, and cerebrospinal fluid cultures were collected in 472 (83%), 326 (58%), and 222 (39%) infants, respectively. Pathogens grew in 1.1% (95% confidence interval [CI], 0.3%-2.5%) of blood, 0.9% (95% CI, 0.2%-2.7%) of urine, and 0.9% (95% CI, 0.1%-3.2%) of cerebrospinal fluid cultures. Cultures from the site of infection were obtained in 320 (57%) infants, with 85% (95% CI, 80%-88%) growing a pathogen, most commonly methicillin-sensitive Staphylococcus aureus (62%), followed by methicillin-resistant Staphylococcus aureus (11%) and Escherichia coli (10%). Four hundred ninety-eight (88%) were hospitalized, 81 (16%) to an ICU. Twelve (2.1% [95% CI, 1.1%-3.7%]) had sepsis or shock, and 2 (0.4% [95% CI, 0.0%-1.3%]) had severe cellulitis or necrotizing soft tissue infection. There was 1 death. Serious complications occurred only in infants aged <28 days.
CONCLUSIONS: In this multicenter cohort, mild, localized disease was typical of omphalitis. SBI and adverse outcomes were uncommon. Depending on age, routine testing for SBI is likely unnecessary in most afebrile, well-appearing infants with omphalitis.