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      Neonatal necrotizing enterocolitis: Pathogenesis, classification, and spectrum of illness

      research-article
      , M.D., , M.D.
      Current Problems in Pediatrics
      Published by Elsevier Inc.

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          Association of coronavirus infection with neonatal necrotizing enterocolitis.

          From the clustered occurrence of numerous cases of necrotizing enterocolitis in newborns, it was possible to associate this disease significantly with infection due to coronavirus-like agents. Prematurity or low birth weight did not seem to affect the development of the disease, at least during the present epidemic. However, associated gas-producing bacteria could influence its severity and play a role in the appearance of pneumatosis. In many aspects the human disease is reminiscent of experimental necrotizing enterocolitis obtained by infection of germ-free newborn animals, as reported in the literature.
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            Acute necrotizing enterocolitis in infancy: a review of 64 cases.

            Sixty-four cases of necrotizing enterocolitis are reviewed. The diagnosis was based on tissue examination in 57 and on the clinical syndrome, including pneumatosis, in 7. Three factors are important in the development of the disease: injury to the intestinal mucosa, bacteria, and feedings. The indications for surgical intervention are pneumoperitoneum, signs of peritonitis, and intestinal obstruction. The importance of stress in the etiology of the disease is confirmed by the high incidence of perinatal complications, particularly hypoxia. The mortality was high, but results are improving with the institution of early aggressive treatment.
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              Clostridium difficile and the aetiology of pseudomembranous colitis.

              Bacterial isolates from 5 patients with pseudomembranous colitis (P.M.C.) were screened for toxin production. Strains of Clostridium from 4 patients produced in vitro a toxin similar to that found in P.M.C. faecal suspension. These were identified as C. difficile. Use of the strains from 2 patients induced a fatal enterocolitis when inoculated orally into hamsters pretreated with vancomycin. The C. difficile that produced the toxin in vitro was then re-isolated from hamster caecal contents. These findings suggest that P.M.C. results from infection with C. difficile and that previous antibiotic therapy produces susceptibility to infection.
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                Author and article information

                Journal
                Curr Probl Pediatr
                Curr Probl Pediatr
                Current Problems in Pediatrics
                Published by Elsevier Inc.
                0045-9380
                0045-9380
                11 August 2004
                April 1987
                11 August 2004
                : 17
                : 4
                : 219-288
                Affiliations
                Case Western Reserve University Department of Pediatrics Division of Neonatology Rainbow Babies and Childrens Hospital Cleveland, Ohio, USA
                Article
                0045-9380(87)90031-4
                10.1016/0045-9380(87)90031-4
                7130819
                3556038
                816dfe01-fdc7-469d-9da7-35a54079dac0
                Copyright © 1987 Published by Elsevier Inc.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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