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Isolated pulmonary valve infective endocarditis (IE) with Enterococcus faecalis in a child with an underlying ventricular septal defect (VSD) is rare. A ten year old girl with a VSD with moderate to severe right ventricular mid cavity obstruction presented with fever and loose stools. Examination did not reveal any peripheral stigmata of IE. Five of six blood cultures sent in two sets 12 hours apart, grew E. faecalis sensitive to β-lactams. 2D echocardiography revealed a 7×4 mm vegetation on the pulmonary valve. She was treated with intravenous antibiotics for 6 weeks. Inflammatory markers normalized by 6 weeks and the vegetation cleared by the 7 th week. Amongst the aetiological agents, isolation of Enterococcus faecalis is rare in children and drug resistance is an emerging problem. Enterococcus species related native valve IE needs a prolonged course of therapy with penicillin G/ampicillin together with gentamicin for 4-6 weeks. Heart failure and cerebral embolization are the most commonly encountered complications.

Introduction: With increasing survival of preterm neonates, oxygen therapy has become an integral part of neonatal respiratory support. In Sri Lanka survival rate of extremely preterm babies is nearly 70%. Most recent studies show oxygen saturations (SpO2) of 91-95% in preterm neonates maximize survival while minimizing side effects such as retinopathy of prematurity. Oxygenation can be optimized by controlling ventilator settings-i.e. fraction of inspired oxygen (FiO2), inspiratory time and mean airway pressure. Objective: To study the SpO2 trend maintained in ventilated (both invasive and non-invasive) preterm babies at the neonatal intensive care unit of Sri Jayewardenepura General Hospital. Method: Study was done in March 2018 on ventilated preterm babies <34 weeks gestation and birth weight <1.5kg. Neonates with pulmonary hypertension, bronchopulmonary dysplasia, cyanotic heart disease, major congenital anomalies and neonates on palliative care were excluded. SpO2 trend and related ventilator settings i.e. FiO2, peak inspiratory pressure / pressure support, and positive end expiratory pressure, were recorded daily at 8am and 2pm. SpO2 trend was observed for 10 minutes and the most persisting value taken to minimize observation bias. Data were analysed using SPSS 20.

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