[Clinical features of rotavirus infections: influence of child age on clinical manifestations]

The aim of the present study was to describe clinical features of rotavirus infections in children and to compare the observed symptoms according to the age of the patients. Clinical files of 278 rotavirus-positive children under 5 years of age were retrospectively examined. The presence of group A rotavirus antigens in stool samples collected from children was detected by direct sandwich enzyme-linked immuno-sorbent assay. Pearson's correlation tests were used to determine the relationship between each clinical sign noticed and patients' age. Among the 278 rotavirus-positive children, 93.9% presented with diarrhea, 79.1% vomiting, 71.6% fever, 37.4% respiratory troubles, and 33.1% neurological signs. Intravenous rehydration was needed for 59.7% of the children. The comparison of clinical signs according to the age showed that diarrhea [p = 0.001], vomiting [p = 0.007], fever [p = 0.045], respiratory troubles [p = 0.01] and dehydration [p<0.001] were significantly more frequent in infants of 1 to 24 months old. The severity of rotavirus illness seems to be directly influenced by child's age. Interestingly, infants of 1 to 5 years old often presented with disease as severe as babies of 6 to 24 months old

[Caustic esophagitis in children: about 86 cases]

Caustic ingestion is a relatively frequent accident in infants. The most redoubtable complication is the oesophageal stenosis which requires a multidisciplinary management. The aim of this work is to study epidemiological, clinic, endoscopic, therapeutic aspects and out comes of caustic esophagitis. We report a retrospective study about 86 cases of caustic esophagitis registered in the paediatric service of Ibn El Jazzar's hospital of Kairouan during the period between 1[st] January 1996 and 31[st] December 2006. The hospital prevalence was 0.3per cent. The median age was 4 years. The most incriminated caustic products were bleach and soda. Clinic examination was more often poor. Among the 86 patients, 41 had a serious caustic esophagitis, all of them received great doses of methyl-prednisolone. 12 patients developed a stenosis. Pneumatic dilatation was done for 9 patients with good results and two patients underwent surgery. However, prevention represents the only way to minimize the dramatic consequences of caustic ingestion on the patient him self, his surroundings and the society

Congenital cutis laxa: report of a case

Congenital cutis laxa is a rare hereditary heterogeneous group of disorder of elastic tissue. It is characterized by abnormally loose skin with a reduction in elastic tissue throughout the dermis. Depending on the mode of transmission and phenotypic expression, congenital cutis laxa has been classified in four types: autosomal dominant; autosomal recessive: types I and II and X-linked recessive. We report a new born girl with the autosomal recessive form of congenital cutis laxa associated with visceral abnormalities. The out come for this form was fatal. The most molecular basis for CCL were known but the therapeutic options are still limited

[Wilson's disease in children - about 21 cases]

Wilson's disease is a familial affection, described the first time in 1912, which has an autosomic recessive transmission. It is characterized by an association of hepatic cirrhosis and neurologic manifestations caused by tissular accumulation of copper. To show clinical, genetic, diagnostic, therapeutic particularities and outcomes of this disease, we carried out a retrospective study concerning three pediatric departments in the Center of Tunisia [Kairouan, Farhat Hached and Sahloul hospitals]. We have collected 21 cases during a period of 17 years [from January 1983 to december 2000]. The finding's age of the disease ranges from 5 to 13 years [mean age 8 years and 9 months]. The sex ratio is 1,1. Consanguinity is found in 90% of cases. Finding circumstances are dominated by edematous and ascitic syndrome [28%] and by hepatomegaly [57.14%] a jaundice [19,5%], a pallor [9.52] and neurologic disorders [19% of cases]. A hepatic cytolysis was found in 38% and a decrease of prothrombin rate in 61% of cases. The ceruloplasmin concentration is lower than 200 mg/1 in 80% and a decrease in the blood rate of copper in 75% of cases. The urinary rate of copper was measured only in 9 patients; it was increased in 8 cases. The therapy consisted in D penicillamin in the first line. Outcome was marked by 3 cases of death. 18 patients are followed up and they are treated by D penicilamin

[ leucinosis-Study of seven cases]

Maple syrup urine disease [MSUD] is an antosomal recessive metabolic disorder caused by decreased activity of this branched chain alpha-ketacid dehydrogenase. Work object is to clear the clinical, therapeutical and evolutive characteristics of this disease, through a retrospective study of seven patients identified over a 12 years period in Kairouan Pediatric department. The mean age of diseasis revelation was 7 days [2 to 12 days]. The consanguinity was found in 5 cases, neurological diseas dominate the clinical manifestations. The DNPH test was positive in five cases. The diagnosis was confirmed by the AAC in blood and OAC in urines. All the 7 new born died in a mean age of 21 days. The light incidence, problems of management and the poor prognosis underline the improtance of antenatal diagnosis

Clinical, biological and evolutional profile of beta-thalassemia in Kairouan. About 55 cases

The authors report a retrospective study concerning 35 cases of beta-thalassemia major, collected in the pediatric service of Ibn El Jazzar Hospital in Kairouan between January 1987 and June 2004. This disease represents 1.19% of hospitalisations. The middle age of diagnosis is of 22 months [3 months - 6 years] with a sex-ratio of 0.6. Clinical symptomatology is dominated by paleness [100% of cases] and splenomegaly [97% of cases]. All patients were treated by long-term chronic blood transfusions with chelation therapy. Eleven partial splenectomies were practiced in ten patients. Three patients died at an average age of 7 years. The prenatal diagnosis, using the amniocentesis, was performed in five cases

[Epidemiology of Haemophilus influenzae b meningitis in Tunisia]

The incidence of Haemophilus influenzae b meningitis [Hib] in children < 5 years in Tunisia was studied through a surveillance system set up in June 2000 and followed for 14 months. Population-based surveillance began in 3 governorates and sentinel surveillance in 2. Children < 5 years suspected of meningitis had lumbar puncture, macroscopic exam, blood count, chemical analysis and culture carried out. In the 14 months, 80 cases of meningitis were recorded. From the population-based surveillance most cases were children < 1 year [73.6%] and boys [64%]. H. influenzae was isolated in 38% of cases, pneumococci in 13% and meningococci in 7%. The incidence of confirmed Hib was 14.4/100 000 children. The estimated cost of identifying and treating Hib meningitis and its complications was greater than the cost of vaccine introduction. Based this study, the Ministry of Health has decided to introduce Hib vaccination

[ albers shomberg syndrome. About 21 cases]

The authors report a retrospective survey concerning 21 cases of the Albers Shomberg syndrome. It is a rare hereditary disease which heterogeneous inheritance but autosomal dominant transmission seems to be most frequent. The average age of patients is of eight and a half [8.5] months, with a masculine prevalence. Circonstances of discovery have been marked by pallor, by megalo-spleno-hepathy [60 %] and by bronchial pneumopathy [35 %]. Under examination, have been noted the following: o ponderal statural delay, in 65 % of cases; o pallor, in 100% of cases o enlarged liver, in 65 % of cases o enlarged spleen, in 85 % of cases. Treatment is symptomatic, based on polytransfusions. Development is unfavourable, with only four [4] survival cases