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Necrotizing Enterocolitis Complicating Sepsis in a Late Preterm Cameroonian Infant

Received: 7 February 2020    Accepted: 19 February 2020    Published: 6 March 2020
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Abstract

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.

Published in American Journal of Pediatrics (Volume 6, Issue 2)
DOI 10.11648/j.ajp.20200602.12
Page(s) 83-86
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Necrotizing Enterocolitis, Prematurity, Preterm, Cameroon

References
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[2] Papillon S, Castle SL, Gayer CP, Ford HR. Necrotizing enterocolitis: contemporary management and outcomes. Adv Pediatr. 2013; 60: 263–279.
[3] Neu J, Walker WA. Necrotizing enterocolitis. N Engl J Med. 2011; 364: 255–264.
[4] 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.
[5] Rose AT, Patel RM. A critical analysis of risk factors for necrotizing enterocolitis. Semin Fetal Neonatal Med. 2018; 23 (6): 374–9.
[6] 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.
[7] Niño DF, Sodhi CP, Hackam DJ. Necrotizing enterocolitis: new insights into pathogenesis and mechanisms. Nat Rev Gastroenterol Hepatol. 2016; 13 (10): 590–600.
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[11] 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).
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[14] 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.
[15] 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].
[16] 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.
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  • APA Style

    Georges Pius Kamsu Moyo, Manuela Nguedjam, Lynda Miaffo. (2020). Necrotizing Enterocolitis Complicating Sepsis in a Late Preterm Cameroonian Infant. American Journal of Pediatrics, 6(2), 83-86. https://doi.org/10.11648/j.ajp.20200602.12

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    ACS Style

    Georges Pius Kamsu Moyo; Manuela Nguedjam; Lynda Miaffo. Necrotizing Enterocolitis Complicating Sepsis in a Late Preterm Cameroonian Infant. Am. J. Pediatr. 2020, 6(2), 83-86. doi: 10.11648/j.ajp.20200602.12

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    AMA Style

    Georges Pius Kamsu Moyo, Manuela Nguedjam, Lynda Miaffo. Necrotizing Enterocolitis Complicating Sepsis in a Late Preterm Cameroonian Infant. Am J Pediatr. 2020;6(2):83-86. doi: 10.11648/j.ajp.20200602.12

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  • @article{10.11648/j.ajp.20200602.12,
      author = {Georges Pius Kamsu Moyo and Manuela Nguedjam and Lynda Miaffo},
      title = {Necrotizing Enterocolitis Complicating Sepsis in a Late Preterm Cameroonian Infant},
      journal = {American Journal of Pediatrics},
      volume = {6},
      number = {2},
      pages = {83-86},
      doi = {10.11648/j.ajp.20200602.12},
      url = {https://doi.org/10.11648/j.ajp.20200602.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200602.12},
      abstract = {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.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Necrotizing Enterocolitis Complicating Sepsis in a Late Preterm Cameroonian Infant
    AU  - Georges Pius Kamsu Moyo
    AU  - Manuela Nguedjam
    AU  - Lynda Miaffo
    Y1  - 2020/03/06
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ajp.20200602.12
    DO  - 10.11648/j.ajp.20200602.12
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 83
    EP  - 86
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20200602.12
    AB  - 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.
    VL  - 6
    IS  - 2
    ER  - 

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Author Information
  • Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon

  • Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon

  • Department of Paediatrics, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Cameroon

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