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Christof Senger - One of the best experts on this subject based on the ideXlab platform.

  • Therapy resistant neonatal seizures, linear Vesicular Rash, and unusually early neuroradiological changes: incontinentia pigmenti
    European Journal of Pediatrics, 2008
    Co-Authors: Gregor W. Kaczala, Manuela A. Messer, Ken J. Poskitt, Juliette S. Prendiville, Jane Gardiner, Christof Senger
    Abstract:

    Case presentation A substance abusing G2P1 mother spontaneously delivered at term an appropriate for gestational age girl. Neonatal seizures appeared at 21 hours and empiric anticonvulsive and antimicrobial treatment was started. At 25 hours, first vesicles appeared. While routine evaluations remained normal, a head CT revealed multifocal ischemic injuries, and a later MRI showed multifocal petechiae and diffusion abnormalities in the corticospinal tracts. The clinical diagnosis of incontinentia pigmenti (stage 1) was secured by histopathology. Follow-up at 13 months showed global developmental delay. Discussion We discuss the unusually early bilateral, fronto-occipital corticomedullar ischemias (CT day 3). On the MR imaging (day 7) extensive symmetric cerebral corticomedullar destruction and diffusion sequences with corticospinal tracts abnormalities are seen, which then evolve (day 26) to extensive symmetric cerebral destruction. We review the literature, genetics, suspected pathophysiology and possible neonatal manifestation. Conclusion Incontinentia pigmenti is rare and, therefore, diagnosis is frequently delayed. Nevertheless, in the setting of therapy refractory seizures, excluded infections, and linear Vesicular Rash, a high index of suspicion is needed. This is the first report of simultaneous corticomedullar involvement as early as the third day of life.

Gregor W. Kaczala - One of the best experts on this subject based on the ideXlab platform.

  • Therapy resistant neonatal seizures, linear Vesicular Rash, and unusually early neuroradiological changes: incontinentia pigmenti
    European Journal of Pediatrics, 2008
    Co-Authors: Gregor W. Kaczala, Manuela A. Messer, Ken J. Poskitt, Juliette S. Prendiville, Jane Gardiner, Christof Senger
    Abstract:

    Case presentation A substance abusing G2P1 mother spontaneously delivered at term an appropriate for gestational age girl. Neonatal seizures appeared at 21 hours and empiric anticonvulsive and antimicrobial treatment was started. At 25 hours, first vesicles appeared. While routine evaluations remained normal, a head CT revealed multifocal ischemic injuries, and a later MRI showed multifocal petechiae and diffusion abnormalities in the corticospinal tracts. The clinical diagnosis of incontinentia pigmenti (stage 1) was secured by histopathology. Follow-up at 13 months showed global developmental delay. Discussion We discuss the unusually early bilateral, fronto-occipital corticomedullar ischemias (CT day 3). On the MR imaging (day 7) extensive symmetric cerebral corticomedullar destruction and diffusion sequences with corticospinal tracts abnormalities are seen, which then evolve (day 26) to extensive symmetric cerebral destruction. We review the literature, genetics, suspected pathophysiology and possible neonatal manifestation. Conclusion Incontinentia pigmenti is rare and, therefore, diagnosis is frequently delayed. Nevertheless, in the setting of therapy refractory seizures, excluded infections, and linear Vesicular Rash, a high index of suspicion is needed. This is the first report of simultaneous corticomedullar involvement as early as the third day of life.

Aaron S Miller - One of the best experts on this subject based on the ideXlab platform.

  • initial presentation of neonatal herpes simplex virus infection
    The Journal of Pediatrics, 2016
    Co-Authors: Alison Curfman, Eric W Glissmeyer, Fahd A Ahmad, Kent E Korgenski, Anne J Blaschke, Carrie L Byington, Aaron S Miller
    Abstract:

    Objective To inform the decision to test and empirically treat for herpes simplex virus (HSV) by describing the initial clinical presentation and laboratory findings of infants with a confirmed diagnosis of neonatal HSV. Study design This is a retrospective case series performed at 2 pediatric tertiary care centers. Infants who developed symptoms prior to 42 days of age with laboratory confirmed HSV from 2002 through 2012 were included. We excluded infants Results We identified 49 infants with HSV meeting these criteria. Most infants (43/49, 88%) came to medical attention at ≤28 days. Of 49 infants, 22 (45%) had disseminated, 16 (33%) central nervous system, and 10 (20%) skin, eye, mouth HSV disease. Eight infants (16%) had nonspecific presentations without the classic signs of seizure, Vesicular Rash, or critical illness (intensive care admission). All infants with nonspecific presentation were ≤14 days, had cerebrospinal fluid pleocytosis, or both. Conclusions The majority of infants with HSV (84%) presented with seizure, Vesicular Rash, or critical illness. A subset of patients (16%) lacked classic signs at hospitalization; most manifested signs suggestive of HSV within 24 hours. Further studies are needed to validate the risk factors identified in this study including age

Eric W Glissmeyer - One of the best experts on this subject based on the ideXlab platform.

  • initial presentation of neonatal herpes simplex virus infection
    The Journal of Pediatrics, 2016
    Co-Authors: Alison Curfman, Eric W Glissmeyer, Fahd A Ahmad, Kent E Korgenski, Anne J Blaschke, Carrie L Byington, Aaron S Miller
    Abstract:

    Objective To inform the decision to test and empirically treat for herpes simplex virus (HSV) by describing the initial clinical presentation and laboratory findings of infants with a confirmed diagnosis of neonatal HSV. Study design This is a retrospective case series performed at 2 pediatric tertiary care centers. Infants who developed symptoms prior to 42 days of age with laboratory confirmed HSV from 2002 through 2012 were included. We excluded infants Results We identified 49 infants with HSV meeting these criteria. Most infants (43/49, 88%) came to medical attention at ≤28 days. Of 49 infants, 22 (45%) had disseminated, 16 (33%) central nervous system, and 10 (20%) skin, eye, mouth HSV disease. Eight infants (16%) had nonspecific presentations without the classic signs of seizure, Vesicular Rash, or critical illness (intensive care admission). All infants with nonspecific presentation were ≤14 days, had cerebrospinal fluid pleocytosis, or both. Conclusions The majority of infants with HSV (84%) presented with seizure, Vesicular Rash, or critical illness. A subset of patients (16%) lacked classic signs at hospitalization; most manifested signs suggestive of HSV within 24 hours. Further studies are needed to validate the risk factors identified in this study including age

Kent E Korgenski - One of the best experts on this subject based on the ideXlab platform.

  • initial presentation of neonatal herpes simplex virus infection
    The Journal of Pediatrics, 2016
    Co-Authors: Alison Curfman, Eric W Glissmeyer, Fahd A Ahmad, Kent E Korgenski, Anne J Blaschke, Carrie L Byington, Aaron S Miller
    Abstract:

    Objective To inform the decision to test and empirically treat for herpes simplex virus (HSV) by describing the initial clinical presentation and laboratory findings of infants with a confirmed diagnosis of neonatal HSV. Study design This is a retrospective case series performed at 2 pediatric tertiary care centers. Infants who developed symptoms prior to 42 days of age with laboratory confirmed HSV from 2002 through 2012 were included. We excluded infants Results We identified 49 infants with HSV meeting these criteria. Most infants (43/49, 88%) came to medical attention at ≤28 days. Of 49 infants, 22 (45%) had disseminated, 16 (33%) central nervous system, and 10 (20%) skin, eye, mouth HSV disease. Eight infants (16%) had nonspecific presentations without the classic signs of seizure, Vesicular Rash, or critical illness (intensive care admission). All infants with nonspecific presentation were ≤14 days, had cerebrospinal fluid pleocytosis, or both. Conclusions The majority of infants with HSV (84%) presented with seizure, Vesicular Rash, or critical illness. A subset of patients (16%) lacked classic signs at hospitalization; most manifested signs suggestive of HSV within 24 hours. Further studies are needed to validate the risk factors identified in this study including age