Bacterial reservoirs in cystic fibrosis

Article Abstract:

Cystic fibrosis is an inherited disease of the endocrine glands, characterized by chronic respiratory infection. The organs most affected are the lungs and pancreas; sweat glands are also involved. Children with cystic fibrosis are at risk for infections in the upper breathing structures. Although upper breathing structures normally have some bacterial growth, in patients with cystic fibrosis the bacteria that colonize and spread to lower breathing structures can be life-threatening. Pseudomonas aeruginosa is a major cause of respiratory infection and death in children with cystic fibrosis. It is hypothesized that if upper airway infection precedes lower airway infection, prophylactic antibiotics could help prevent the progression of these life-threatening infections in the lungs. It is suspected that bacterial infections caused by P. aeruginosa may come from contaminated nebulizers, devices that administer medication and moisture through a fine, atomized spray. Children with cystic fibrosis often use nebulizers to break-up the thick mucous that pools in the breathing structures. To see if bacteria in the upper respiratory tract, bacteria-contaminated nebulizers, or nebulizing solutions predispose children to infections of the lower breathing structures, 73 children with cystic fibrosis were examined. Thirteen children with positive colonization with P. aeruginosa in the lungs were compared with 18 children who tested negative for this bacteria. Cultures taken from nebulizer devices, solutions, toothbrushes and the upper airway structures were compared with cultures taken from sputum (mucous from the lower airway) and cough swabs. Two bacteria, Haemophilus influenza and Staphylococcus aureus, were found in both groups, but did not correlate well with sputum cultures. Children with negative sputum from the lower structures had no P. aeruginosa in the upper airway, except for one child who contracted P. aeruginosa during the study. The results provide no evidence that supports the transfer of P. aeruginosa infection from the upper to the lower airway. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infection, Development and progression, Contamination, Cystic fibrosis, Nebulizers and vaporizers, Nebulizers (Medicine), Vaporizers, Pseudomonas infections, Cystic fibrosis in children

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Scalp tumours mimicking encephaloceles

Article Abstract:

An encephalocele is a herniation of the brain. It occurs when a portion of the brain projects through a gap in the skull and forms a large bulge under the scalp. This condition can be congenital (present at birth) or it can be caused by trauma to the head. Congenital scalp tumors are rare, but they may look similar to encephalocele in that both conditions often appear as a large mass or bump under the scalp. However, the two conditions can be differentiated based on the observations that hair does not usually grow on an encephalocele and encephaloceles tend to be located near the middle portion of the skull. A large mass under the scalp that is not near the middle of the skull is unlikely to be an encephalocele. This article describes the case reports of two infants born with benign scalp tumors that looked similar to encephaloceles. In the first case, X-rays were of little value in determining whether the mass was located entirely outside of the skull. In the second case, ultrasound showed that the mass did not penetrate into the brain. In both cases, the tumors were easily removed since they were located under the scalp and outside the skull. Five years after surgery both children were healthy and neither tumor had recurred. (Consumer Summary produced by Reliance Medical Information, Inc.)

Infants (Newborn), Newborn infants, Skull, Scalp, Encephalocele

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Respiratory problems and cystic adenomatoid malformation of lung

Article Abstract:

There are several congenital cystic diseases affecting the lungs. Although they are uncommon, these cystic lung diseases are important causes of neonatal respiratory distress. Cystic adenomatoid malformation of the lung, in which some lobes of the lung grow abnormally large, but do not function, can cause shifting of structures within the chest and impair normal lung function. The presentation, treatment, and prognosis of this disease are described. The disease is easily confused with diaphragmatic hernias, and X-rays should be taken with a nasogastric tube in place (a narrow tube threaded through the nose and into the stomach) to allow discrimination between the two diseases. Removal of the involved lung lobes soon after diagnosis is very important for a successful outcome; in most cases, the remaining lobes provide satisfactory respiratory function. This condition is regarded as a surgical emergency; urgent referral to a regional pediatric center is appropriate once the diagnosis of cystic adenomatoid malformation is made in an infant. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Birth defects, editorial

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