Ottobre 2013 - Volume XXXII - numero 8
Pagine elettroniche
1Scuola di Specializzazione in Pediatria, Università di Ferrara
2Clinica Pediatrica, Arcispedale Sant’Anna, Ferrara
Indirizzo per corrispondenza: sylvie.tagliati@student.unife.it
Key words: Hypercalcemia, Vitamin D, Nephrocalcinosis
The article presents a case of severe hypercalcemia due to hypervitaminosis D in a 5-month-old infant. The child was fed with infant formula. He received 2 drops of 25-hydroxy vitamin D3/day since he was born. His clinical features showed growth retardation, anorexia and dehydration, axial hypotonia, psychomotor development retardat and closed anterior fontanel. Investigations showed low levels of parathormone, marked hypercalciuria, high levels of 25-OH vitamin D3 and nephrocalcinosis established by ultrasound evaluation. The infant was treated with parenteral hydration, oral prednisone and oral potassium citrate. The Vitamin D supplementation was stopped. Furthermore, the regular feeding milk was replaced with a new low-calcium and vitamin D-free one. This clinical case has to be taken as an example to discourage the routine use of vitamin D metabolites as prophylaxis of hypovitaminosis D.
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Pagine elettroniche
SUP>1UCO Clinica Pediatrica, Università di Trieste; 2SC Pediatria d’urgenza e Pronto soccorso pediatrico; 3SC Neonatologia e terapia intensive neonatale, IRCCS Materno-Infantile “Burlo Garofolo”, Trieste
Indirizzo per corrispondenza: elisazanelli@hotmail.it
Recurrent GBS infection represents a potentially preventable subset of late-onset GBS sepsis. It occurs in 0.5% to 3.0% of infants. Mother can represent the first source of late-onset disease (LOD) and some case reports attribute responsibility to breast milk. The paper describes a case of a septic infant who had a GBS positive blood culture and who, after appropriate antibiotic treatment, experienced relapse. At that time a bacterial culture of the expressed breast milk tested positive for GBS and the mother was treated with antibiotic therapy. As reported in literature, sometimes the suspension of breast milk does not prevent relapse, demonstrating that GBS-colonized milk is not responsible of the recurrence, but rather an epiphenomenon of LOD. However, the research of GBS on breast milk should be carried out in the late-onset neonatal sepsis and an eradicating antibiotic treatment of GBS-positive mother could prevent recurrent GBS sepsis.
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