Abstract/References

Investigation of biomarkers in a rare case of fulminant necrotizing enterocolitis in a preterm infant

Toshihiko Nakamura, Shota Inoue, Kana Ito, Eisuke Fukama, Tomoaki Nomura, Daisuke Hatanaka, Michiko Kusakari, Hidehiro Takahashi, Shingo Yamada

Author information
  • Toshihiko Nakamura

    Department of Neonatology, Japanese Red Cross Musashino Hospital

  • Shota Inoue

    Department of Neonatology, Japanese Red Cross Musashino Hospital
    Department of Pediatrics, National Defense Medical College

  • Kana Ito

    Department of Neonatology, Japanese Red Cross Musashino Hospital
    Department of Pediatrics, National Defense Medical College

  • Eisuke Fukama

    Department of Neonatology, Japanese Red Cross Musashino Hospital

  • Tomoaki Nomura

    Department of Neonatology, Japanese Red Cross Musashino Hospital

  • Daisuke Hatanaka

    Department of Neonatology, Japanese Red Cross Musashino Hospital

  • Michiko Kusakari

    Department of Neonatology, Japanese Red Cross Musashino Hospital

  • Hidehiro Takahashi

    Department of Neonatology, Japanese Red Cross Musashino Hospital

  • Shingo Yamada

    Shino-Test Corporation

Abstract

We encountered a very rare case of fulminant necrotizing enterocolitis (F-NEC) in a preterm male baby. The course of NEC and sepsis in this case was clearly different from the usual course. After onset at 14 days of life, catheter-related bloodstream infection was first assumed, and antibiotics and γ-globulin administration were started. However, 12 hours after onset, the baby’s abdominal distension increased remarkably, and his entire abdominal wall turned red to purple. Escherichia coli were isolated from the blood culture, but the catheter tip culture was negative. Exchange transfusion was performed 32 hours after onset, but no significant changes were observed in the baby’s general condition, and he died 46 hours after onset. The acute phase reactants of CRP and α1-acid glycoprotein increased, but haptoglobin did not. Although IL-1β and TNFα increased as expected with sepsis, IL-6, IL-8, IL-10, and G-CSF however increased to a greater extent than expected. From the above, we diagnosed the development of intestinal necrosis as a result of widespread intestinal ischemia, and that sepsis was associated with this poor condition.

The cintent of reseach paper

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