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

[Bilateral pulmonary embolism secondary to the venous thrombosis in child nephrotic syndrome]

Nephrotic syndrome is known to be associated with thrombosis in child. These complications are severe. The authors reported a case of a 4 year-old boy who was hospitalized for a corticoresistant nephrotic syndrome. He has developed a bilateral pulmonary embolism secondary to the extension of the thrombosis of the superior vena cava. The treatment consisted in the association of a low molecular weight heparin and vitamin K antagonists for 8 months. The outcome was good after 18 months without sequealea, and the remission of nephrotic syndrome was obtained after using cyclosporine

La Syphilis conge'nitale pre'coce [a'propos de 35 cas]

This retrospective study is about 35 cases of precocious congenital syphilis collected during a period between 1980 and 1994. Data analysis permit to reveal that 77% of pregnancies are not supervised. The majority of cases are nurslings which represent 60% of the cases. Clinical pictures are dominated by polyvisceral forms [65%], they contain an hepatomegaly [57%], a spleno megaly [48%] and osseous affection as osteochondritis [77%], periostitis [50%] and osteomyelitis [5%]. The syphilis serology has been positive in [84%] for the VDRL and 78% for the TPHA. Under penicillinotherapy, evolution was favorable in 69% of cases, whereas 30% of patients died. This important mortality emphasizes on the interest of this foetopathy prevention, whose frequency increases with recrudescence of sexual transmitted diseases and unfollowed up pregnancies

L'ictere de l'infection urinaire. [Q propos d'un eas]

Jaundice was the presenting feature in a 30 day-old newborn suffering from urinary tract infection [UTI], due to Escherichia coli. The features and the mechanisms of jaundice complicating UTI are discussed

hemosiderose pulmonaire idiopathique a revelation precoce [a propos d'un cas]

Idiopathic pulmonary hemosiderosis [IPH] is a very rare disease but not exceptionel. It's characterized by spontaneous intra alveolar bleeding, occuring by access with remissions. It concerns generaly the child rarely the young adult. In the light of one observation revealed early with review of literature, the authors discuss the clinical manifestations of this disease whose monosymptomatic forms have to attract attention. In our country, despite the presence of a complete clinical picture, the diagnosis of IPH is returned secondarily after the tuberculosis because of the endemic character of this latter. A physiopathological study of a pulmonary biopsy seems to be necessary both for a better diagnosis and prognosis. Treatment by corticoids and/or immunosuppressive drugs is controversed. The prognosis of this affection is usually poor

Pott's disease in the children: the contribution of the radiology [50 cases]

Pott's disease is still a public health problem. The diagnosis must be precocious. The radiology is necessary and permits also to value the evolutivity of the disease and the therapeutic efficiency. In this study, we report 50 cases of pott's disease in the child and we insist on the elements of the precocious diagnosis especialy, we are based on radiologic examinations. The radiologic images are divided into discal infections in 47 cases of anterior cuneiform agglomeration that causes the gibbosity in 31 cases and geods in 10 cases. The abscesses are found in 30 cases and stored reach in 5 cases. We conclude from this study the important profile of the radiologic exploration in the orientation of the diagnosis of the tuberculous spondylodicitis in early stage without missing the usefulness of the new methods of medical imageries [scintigaphia, TDM, IRM] that permit to arrive at the diagnosis of lott's disease before the conventional radiographies

[Interest of the medical imagery in Ewing sarcoma]

The authors try to call to mind the radiologic aspects of the Ewing Sarcoma and the interest of the medical imagery in the complete physical examination of extension and the supervision of this tumor. This is done through a retrospective study of4l cases collected during 7 years an a half which occurred in 35 children an 6 young adults. The age of the patients is between 6 and 36 years and the sex ratio is 1,9. For the diagnosis of S.E., the standard radiologic examination is generally sufficient, except for some atypical radiologic forms where the contribution of the other means of exploration is very helpful. So, the plat bones and short bones are reached in 51% of the cases. The osteolysis is found in all the patients of this series. It is associated to the osteo-condensation in 43% of the cases. The cortical is either broken or destincted in all the cases. The periosted appositions are plurilamellar and/or spicular like a [afire of herb] in 61% of the cases. The spur of Codman is present in 34% of the cases. The soft parts are invaded in 97% of the cases. These results confirm those of the literature, however the spur of Codman predominant in this series inherent to the delay of consultation of the patients. For the complete physical examination of the extension, .rather than the standard radiologic, the scanner, the NRM and the osseous scintigraphia are very helpful. For the search ofthe pulmonary metastasis, the thoracic radiography is indispensable but the detection of early metastasis still relative to the scanner. The supervision of the treated tumors is devoted to the standard radiography and especially the scanner which appreciates this regression permiting in irradiated cases, to distinguish the tumoral recidivism from the postradic fibrosis. This distinction can better be done with the NRM. The autors propose a decisional schema