Onesimo Roberta, Fioretti Maria, Pili Stefania, Monaco Serena, Romagnoli Costantino, Fundarò Carlo
Pediatrics Department, Catholic University of Sacred Heart, Rome, Italy.
BMJ Case Rep. 2011 Oct 16;2011:bcr0820114677. doi: 10.1136/bcr.08.2011.4677.
Purulent lymphadenitis is rare in newborn and is associated with prematurity and invasive procedure. Neonatal staphylococcal infections due to skin interruption during intramuscular vitamin K administration and national metabolic screening programme (heel prick or Guthrie card test) have been already previously described. This is a report of a premature infant who developed an inguinal adenitis as a result of late complications from heel pricks. The diagnosis was made on clinical grounds and confirmed by ultrasound scans. Staphylococcus aureus was isolated. Bacteremia did not occur and the lymphadenitis had a complete resolution with antimicrobial therapy. The heel prick is a well-established procedure in neonatal practice, nevertheless it is not risk-free. The attention to signs of infections is important to avoid complications such as purulent lymphadenitis, abscess formation and septicemia. Best practice prevention and control in minimising the risk of infections are the most important intervention to prevent this complication.
脓性淋巴结炎在新生儿中罕见,与早产和侵入性操作有关。先前已有关于因肌肉注射维生素K期间皮肤破损以及国家代谢筛查项目(足跟采血或古思里卡片试验)导致新生儿葡萄球菌感染的报道。本文报告了一名早产儿因足跟采血的晚期并发症而发生腹股沟淋巴结炎的病例。根据临床症状做出诊断,并经超声扫描确诊。分离出金黄色葡萄球菌。未发生菌血症,经抗菌治疗后淋巴结炎完全消退。足跟采血是新生儿科常用的操作,但并非没有风险。关注感染迹象对于避免脓性淋巴结炎、脓肿形成和败血症等并发症很重要。最佳的预防和控制措施以降低感染风险是预防该并发症的最重要干预手段。