The Journal of the Kentucky Medical Association
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Although hypoxic-ischemic encephalopathy (HIE) is relatively rare, it commonly results in devastating long-term mortality and death. Intervention against this condition has been limited and frustrating. ⋯ Many questions, however, still remain unanswered about the use of hypothermia. Long-term efficacy and safety of hypothermia needs to be established before it can be recommended "as standard of care" for the treatment of neonatal HIE.
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Infant Botulism (IB) is a relatively uncommon, though potentially life-threatening neuroparalytic illness caused by the toxins elaborated by Clostridium botulinum (C botulinum). We describe two cases of Infant Botulism. Both these infants presented with a sepsis-like picture and were unsuspectingly treated with the conventional antibiotics ampicillin and gentamicin. ⋯ We suggest that cefotaxime be carefully considered instead of gentamicin in the initial management of infants presenting with a sepsis-like clinical picture and associated history of constipation, recent onset of hypotonia, poor feeding and/or drooling. Clinical trials evaluating human Botulism Immune Globulin (BIG) are under way by the California Department of Health. This article comes at a very timely moment because once FDA approved, BIG will be the only specific treatment available for this illness.