ABSTRACT
S pneumoniae is a rare cause [1-8%] of maternofetal infection causing an important morbi-mortality in the newborn and the mother. To report 3 cases of early neonatal infection due to S pneumonia. Three cases of early neonatal infection due to S pneumoniae are reported. The three newborns were at term or near term babies with a vaginal delivery in two cases and a caesarean section in one case. They presented severe symptoms, with a progressive onset after birth, leading to hypoxemic pneumonia in one case and to septic shock in two newborns associated with meningitis in one case. S pneumoniae was isolated in the blood culture in two patients with positive soluble antigens in the cerebrospinal fluid in one case and positive peripheral bacteriological swabs in the other case. In the third case, S pneumoniae was isolated in the tracheal sample of the newborn and his mother. S pneumoniae was sensitive to ampicillin in two patients and of decreased sensitivity to ampicillin in one patient. The clinical course was favourable in the three patients after hospitalization in the intensive care unit. Early neonatal infections caused by S pneumonia are rare and are an important cause of morbi-mortality in the newborn and the mother
Subject(s)
Humans , Male , Streptococcus pneumoniae , Infant, NewbornABSTRACT
There is limited literature describing severe community acquired methicillin-resistant S aureus [CA-MRSA] in children admitted to an intensive care unit. To review clinical features and outcome of children admitted in a Tunisian pediatric intensive care with CA-MRSA. Retrospective chart review of patients coded for CAMRSA over 10 years. There were 14 [0.32% of all admissions] patients identified with severe CA-MRSA. The median age was 3 months [range, 0.5-156 months]. All patients had pulmonary involvement. Six children [42.8%] developed septic shock. Two [14.3%] patients had multifocal infection with deep venous thrombosis. Two [14.3%] patients died. Severe CA-MRSA pneumonia dominated presentation. The mortality of CA-MRSA infection in our series is lower than reported in the literature
ABSTRACT
The clinical polymorphism and the low yield bacteriological tests make the diagnosis of tuberculosis [TBC] in children often difficult. The aim of this report is to specify hospital incidence of childhood TBC and to discuss problems in diagnosis. We reviewed retrospectively cases of TBC enrolled at Medicine A Department in Children's Hospital of Tunis during the last ten years [1998 - 2007]. Diagnosis of TB was supported according to bacteriological or histological confirmation or regarding the association of epidemiological data [TB contagium], clinical and radiological findings and favourable outcome with anti tuberculous drugs. Thirty children had TBC. They were 18 girls and 12 boys. The main age at diagnosis was 8. 6 years [3 months-14 years]. All children were vaccinated with BCG. Thirteen patients had definite familial history of TBC contact. Tuberculin-skin test was positive in 15 patients. The diagnosis was supported within a mean period of 44 days [8, 240 days]. Pulmonary TBC occurred in five patients and extra-pulmonary TBC in 25. Four patients had more than two TBC localizations. Miliary and TBC meningitis occurred in seven patients. The rate of diagnosis confirmation was 40%. Clinical outcome improved in 29 children with anti tuberculosis therapy while one infant died with miliary TBC. Five patients developed pleural, neurological or bone sequelaes and another patient presented autoimmune bicytopenia, diffuse bronchectasis and pulmonary aspergillosis. TBC occurs in 0, 91/ year/1000 hospitalized children in our institution. Low diagnosis confirmation rate was observed with infants and in pleural and primary TBC. Although all patients received BCG vaccine, 23. 3% of them developed a life-threatening form of TBC