The Diseases and deformities of the fœtus Volume 2 - Softcover

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1895 Excerpt: ... CHAPTER IV. SCLEREMA NEONATORUM--Continued. DIAGNOSIS; PROGNOSIS J TREATMENT; LITERATURE. Diagnosis. THERE ought to be little difficulty in recognising a case of sclerema neonatorum if the occasional occurrence of the malady is borne in mind, and if its distinctive clinical features have been clearly impressed upon the observer's mind. The association of marked lowering of the body-temperature, with depression of all the organic functions, and with the development of cedematous or indurative changes in the skin and subcutaneous tissue in an infant a few days old, points directly to the existence of this disease. Further, the diagnosis will be much easier if the observer have previously seen a case of the same nature. Since, however, sclerema has been constantly confounded with other pathological conditions, it will be well briefly to point out the chief factors in the differential diagnosis. I. From Erysipelas Neonatorum. There seems to be little doubt that many of the older writers confused together sclerema and erysipelas neonatorum; thus the cases reported by Horn (16) seem to have been instances of the latter malady. Erysipelas, however, usually begins near the umbilicus or on the face, and rapidly involves the skin in the immediate neighbourhood; the affected parts are red in colour, warm to the touch, and painful on pressure; and the temperature of the body is raised. It must also be borne in mind that it is possible that erysipelas may occur as a complication of sclerema; in such circumstances the diagnosis will of necessity be much more difficult. 2. From Scleroderma. Whilst erysipelas is most likely to be confounded with the cedematous variety of sclerema, scleroderma resembles most closely the indurative type. The age of the patient will here be ...