Scedosporium prolificans is a saprophytic fungus responsible for an increasing number of infections among immunocompromised hosts. Historically, disseminated infection with this organism has resulted in death. We report on a pediatric patient who developed overwhelming S. prolificans sepsis after induction chemotherapy for acute lymphoblastic leukemia. She is well 18 months after the diagnosis of fungal sepsis and continues to receive chemotherapy for leukemia, which remains in remission.
Alloimmune neonatal neutropenia (ANN) is reported for the first time in two Australian aboriginals. Both infants displayed the typical clinical features of ANN with profound neutropenia which persisted for 7 weeks and only minor infectious episodes. However, management strategies differed for the two infants because in one case (complicated by uncertain paternity) serological confirmation of ANN was not obtained until after recovery of the infant's neutrophil count. The maternal antibodies could not be assigned to known neutrophil antigen specificities and a new antigen may be involved. The antibodies were reactive with > 99% of neutrophils in a Caucasian population. Aboriginals comprise 1% of the total population of Australia and 1-2% of the obstetric population at our institution. Thus, ANN may be an unrecognized disorder in this ethnic group and a possible cause of neonatal infection and mortality.
by fetal blood sampling looking for the evidence of parvovims infection. However, intrauterine transfusion should be reserved for hydropic fetuses with a low haernatwrit. More studies are needed to clarify further the natural history of the infection in the fetus and the long-term sequelae in surviving infants.
References1.Guidozzi F, Ballot D. Rothberg AD. Human parvovirus infection in an obstetric population. A prospective study determining fetal outcome. J Reprod Med 1994, 39:36-38. 2. Boyce BF, Forgie I. An outbreak of 'slapped cheek' parvovirus infection (erythema infectiosum) in a Scottish street. Scot Med 3.Schwaru T. Roggendorf M. Hoftenbager B et al. Human pllrvovirus B19 infection in pregnancy. Lancet 1988; 2:566-567. 4. Brandenburg H. Los FJ and Cohen-Overbcek TE. A case of early intrauterine parvovirus B19 infection. Prenat Diagn 1996; 16:75-77. 5. Public Health Laboratory Service Working Party on Fifth Disease. Prospective study of human parvovirus (B19) infection in pregnancy. BMJ 1990. 300: 1166-1 170. 6. Anand A. Gray E. Brown T. Clewlcy J, Cohen BJ. Human parvovirus infection in pregnancy and hydrops fetalis. N Engl J Med 1987; 316183-186. 7. Towbin JA. Griffin LD. Manin AB et al. Intrauterine adenovkal myocarditis presenting 8s nonimmune hydrops fetalis: diagnosis by polymerase chain reaction. Pediatr Infect Dis J 1994, 13:144-I so. J 1987; 32~70-1 I. 8. Sahakian V, Weiner CP, Naides SJ, Williamson R Scbanxh L. Intrauterine transfusion treatment of mnimmune hydmps EeraIis secondary to human parvovirus B19 infection. Am J Obstn Gynecol1991; 164.1090-1C91. 9. Peters MT, Nim1aide.s KH. Cordccentesis for the diagnosis and treatment of human fetal parvovirus infection. Obstet Gyoecol 1990,75:501-S04. 10. Carrington D, Whittle M, Gibson Aet al. Maternal s e w Alphafetoprotein -a marker of fetal aplastic crisis during intrautexine human parvovhs infection. Lancet 1987; 1:433435. 1. Saller DN, Rogers BB, Canick JA. M a t e d serum biochemical markers associated with fetal parvovirus B19 infection. Rcnat Diagn 1993; 13:467471. 2.Sheikh A, b e s t J, O'Shea M. Long-term outcome in fetal hydrops from parvovirus B19 infection. Am J Obstet Gynecol 1992; 167:337-341. 3. Duthie SJ. Walkinshaw SA. Parvovinrs associated fetal hydrops: reversal of pregnancy induced proteinuric hypertension by in utero fetal transfusion. Br I Obstet Gynaecol 1995; 1021011-1013. 4.Petrikovsky BM, Baker D, Schneider E. Fetal hydrops secondary to human parvovirus infection in early pregnancy. h n a t Diagn 1996; 16342-344. 5. Pryde PG, Nugent CE, Ridijian Get al. Spontaneous resolution of nonimmune hydrops fetalis secondarj to human parvovirus B19 infection. Obstet Gynecol 1992; 79859-861. 16.Kovacs B, Carlson D. Shahbahrami B, Platt L. &natal diagnosis of human parvovirus B19 in nonimmune hydrops fetalis by polymerase chain reaction.
EDITORIAL COMMENT:We accepted this case forpublication because it seem to link graft versus host disease with intrauterine transfusions. Since the association of transfusion with graft versus host disea...
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