Necrotizing Enterocolitis Complicating Sepsis in a Late Preterm Cameroonian Infant
American Journal of Pediatrics
Volume 6, Issue 2, June 2020, Pages: 83-86
Received: Feb. 7, 2020;
Accepted: Feb. 19, 2020;
Published: Mar. 6, 2020
Views 314 Downloads 74
Georges Pius Kamsu Moyo, Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
Manuela Nguedjam, Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
Lynda Miaffo, Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon
Background: Necrotizing enterocolitis (NEC) is a leading cause of death from gastrointestinal disease in premature infants. It has been recognized for decades as the most common life-threatening medico-surgical intestinal emergency in newborns. The overall incidence of NEC has been reducing steadily during the past few years and has become even less common in late preterm and in term infants. However, accumulating evidence over the years suggest that NEC should be considered in a broader set including these subpopulations with risk factors. The disease might be associated with short and long-term complications, prolong hospitalization, and be cost worthy. Medical treatment alone may be done with considerable success, when diagnosed early enough with mild or moderate severity. In most cases, a multidisciplinary approach is recommended as much as possible. Nevertheless, primary prevention by breastfeeding promotion and standardized formula replacement when indispensable is pertinent. Method: We present and discuss based on current reviews, a case of early onset NEC complicating sepsis in a late preterm. Results: It appears that medical management alone which is indicated for moderate NEC may be quite successful when based on broad spectrum antibiotics that cover gram negative bacteria and anaerobes, together with intensive and supportive cares. Conclusion: NEC may occur precociously in late preterm. The prompt diagnosis may be made easier by radiological exams. A multidisciplinary approach for the management of stage II or moderate NEC may be more efficient. Breastfeeding remains an effective prevention against NEC.
Georges Pius Kamsu Moyo,
Necrotizing Enterocolitis Complicating Sepsis in a Late Preterm Cameroonian Infant, American Journal of Pediatrics.
Vol. 6, No. 2,
2020, pp. 83-86.
Stoll BJ, Hansen NI, Bell EF, Walsh MC, Carlo WA, Shankaran S et al. Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993–2012. JAMA. 2015; 314: 1039–1051.
Papillon S, Castle SL, Gayer CP, Ford HR. Necrotizing enterocolitis: contemporary management and outcomes. Adv Pediatr. 2013; 60: 263–279.
Neu J, Walker WA. Necrotizing enterocolitis. N Engl J Med. 2011; 364: 255–264.
Fitzgibbons SC, Ching Y, Yu D, Carpenta J, Kenny M, Weldon C et al. Mortality of necrotizing enterocolitis expressed by birth weight categories. J Pediatr Surg. 2009; 44 (6): 1072–5; discussion 1075-6.
Rose AT, Patel RM. A critical analysis of risk factors for necrotizing enterocolitis. Semin Fetal Neonatal Med. 2018; 23 (6): 374–9.
Battersby C, Santhalingam T, Costeloe K, Modi M. Incidence of neonatal necrotising enterocolitis in high-income countries: a systematic review. Arch Dis Child Fetal Neonatal Ed. 2018; 103 (2): F182–F189.
Niño DF, Sodhi CP, Hackam DJ. Necrotizing enterocolitis: new insights into pathogenesis and mechanisms. Nat Rev Gastroenterol Hepatol. 2016; 13 (10): 590–600.
Molteni M, Gemma S, Rossetti C. The Role of Toll-Like Receptor 4 in Infectious and Noninfectious Inflammation. Mediators Inflamm. 2016; 2016: 6978936.
Hamilton BE, Martin JA, Osterman MJK, Curtain SC. Births: preliminary data for 2014. Natl Vital Stat Rep. 2015; 64: 1–19.
Yee WH, Sonraisham AS, Shah VS, Aziz K, Yoon W, Lee SK. Incidence and timing of presentation of necrotizing enterocolitis in preterm infants. Pediatrics. 2012; 129: e298–e304.
Alganabi M, Lee C, Bindi E, Li Bo, Pierro A. Recent advances in understanding necrotizing enterocolitis [version 1; referees: 2 approved] F1000Research 2019, 8 (F1000 Faculty Rev): 107 (https://doi.org/10.12688/f1000research.17228.1).
I YF, Lin HC, Torazza RM, Parker L, Talaga E, Neu J. Gastric residual evaluation in preterm neonates: a useful monitoring technique or a hindrance? Pediatr Neonatol. 2014; 55: 335–340.
Janssen Lok M, Miyake H, Hock A, Daneman A, Pierro A, Offringa M. Value of abdominal ultrasound in management of necrotizing enterocolitis: a systematic review and metaanalysis. Pediatr Surg Int. 2018; 34 (6): 589–612.
Yikilmaz A, Hall NJ, Daneman A, Gerstle JT, Navaro OM, Monnedin R, et al. Prospective evaluation of the impact of sonography on the management and surgical intervention of neonates with necrotizing enterocolitis. Pediatr Surg Int. 2014; 30: 1231–1240.
Niemarkt HJ, De Meij TGJ, Van de Velde ME, Van der Schee MP, Van Goudoever JB, Kramer BW et al. Necrotizing enterocolitis: a clinical review on diagnostic biomarkers and the role of the intestinal microbiota. Inflamm Bowel Dis. 2015; 21: 436–444. [PubMed: 25268636].
Heida FH, Hulsher JBF, Schunrink M, Timmer A, Kooi EMW, Bos AF et al. Intestinal fatty acid-binding protein levels in Necrotizing Enterocolitis correlate with extent of necrotic bowel: results from a multicenter study. J Pediatr Surg. 2015; 50: 1115–1118.
Coggins SA, Wynn JL, Weitkamp JH. Infectious causes of necrotizing enterocolitis. Clin Perinatol. 2015; 42: 133–154. ix. [PubMed: 25678001].
Good M, Sodhi CP, Egan CE, Afrazi A, Jia H, Yamaguchi Y et al. Breast milk protects against the development of necrotizing enterocolitis through inhibition of Toll-like receptor 4 in the intestinal epithelium via activation of the epidermal growth factor receptor. Mucosal Immunol. 2015; 8: 1166–1179.