[Evaluation of bucco dental state to hemophiliac Moroccan children: a comparative enquiry transverse]

The few of interest of the hemophiliac children and their parents of bucco dental health and the focusing of the attention on the disease returns the bucco dental affections serious with bleeding and / or infections. A transverse epidemiologic enquiry has been realized in 2001 to the center hospital Ibn Rochd in order to evalue the bucco dental state to hemophiliac children in comparison with healthy group. The sample was composed of 46 hemophiliacs and 92 healthy children matched in age and in sex. Some of general state parameters to the ill population have also been studied at the time of this investigation. Thus, We were able to raised four times more of A hemophilia that B type without significant difference between major shape, attenuated and moderate. The hemorrhages oral was especially due to the fall of primary teeth [26,1%] and to the teeth extractions achieved without precaution [1 7,4%]. The results of bucco dental state showed the predomi-nance of the bad hygiene at the two groups. 60,9% of hemophiliac against 47,8% of healthy children had a bad control of hygiene. Decayed index were similar between the ill group [cao = 2,92 et CAO = 1,32] and the healthy group [cao = 2,18 et CAO = 1,15]. The Teeth malocclusions were more frequent at the hemophiliac children that at the other with a meaningful difference

Mediterranean spotted fever revealed by multivisceral damage

We report a case of Mediterranean spotted fever revealed in a 3 year-old girl by severe neurological symptoms as convulsions, feverish coma and generalized hypotonia, associated to acute diarrhoea and digestive haemorrhage. Contact with dogs, wrist bedsore and positive rickettsiosis seroconversion allowed us to have the diagnosis. Encephalic MRI showed an ischemic vasculocerebral accident that raises the problem of rickettsiosis lesions pathogenesis

[Diagnostic difficulties of the atypical onset of Kawasaki disease: a 8 cases report]

Kawasaki's disease is a multisystemic vasculitis that most often affects young children. It is known for inducing adverse cardiac effects, especially the development of coronary aneurysms that could lead to death. The diagnosis is based only on clinical criteria, and needs the presence of typical fever and 4 out of the 5 other clinical criteria. The aim of this study is to highlight the occurrence of atypical onset of the disease that should in no way delay the diagnosis and the start of treatment. We reviewed 13 cases of Kawasaki disease treated at Pediatrics 3 in Children Hospital of Casablanca from 1996 to 2002: 8 had atypical Kawasaki disease with particular clinical onset or biological parameters and/or evolution, that initially led to other diagnosis. The clinical onset manifestations included one case of uveitis with blindness, another case of febrile purpura, the third case with pyretic hepatomegaly and liver cytolysis. A diffuse cervical lymph node enlargement was described in one case and led to the diagnosis of haemopathy. Two patients had neurological involvement, in one case with ataxia in the other with headache and strabismus. A 12 year-old child had polyarthritis and the diagnosis was made retrospectively and the evolution was sub acute. The last patient had respiratory manifestations with coughing, fever and radiological atelectasia. The risk of coronary aneurysms directs to suspect early Kawasaki disease in very young children with persistent fever and inflammatory patterns, even in the absence of all typical manifestations