[Acute transverse myelitis in pediatric intensive care: a 3 cases report]

Acute transverse myelitis [ATM] is a rare disorder caused by an inflammatory syndrome of the spinal cord. We report 3 cases of ATM managed in the intensive care unit of the Children's hospital of Tunis in order to precise clinical, therapeutic and prognostic particularities of the severe forms of ATM complicated with acute respiratory insufficiency [ARI]. Cases: the three patients were aged respectively of 6, 9 and 13 years. The 3 girls presented with ARI requiring mechanical ventilation in 2 cases. The diagnosis was confirmed by the cerebrospinal MRI in the 3 cases. The etiological research was negative in all cases. Intravenous methylprednisolone was given in the 3 cases. One patient died. The death was caused by acute neurovegetative disorders. At 6 months follow up, one patient was asymptomatic. The other patient had urinary incontinence and a partial lower limb weakness

[Effects of high frequency oscillatory ventilation on gas exchanges in pediatric patients with acute respiratory failure]

There is increasing use of high frequency oscillatory ventilation [HFOV] in [rescuing] pediatric patients with acute respiratory failure [ARF], failing conventional ventilation [CV]. Because HFOV is considered to be a [rescue] therapy, intervention with HFOV is usually in the later stages of respiratory failure, after a prolonged CV. The objective of this study was to evaluate the effectiveness of HFOV, used as [early rescue] therapy, on gas exchanges in pediatric patients with ARF and diffuse alveolar disease. An HFOV protocol for pediatric patients with ARF was established with the following entry criteria: body weight of /= 90% and PaO[2]

[About two cases of highly probable transfusion induced malaria]

Indigeneous malaria has not been seen in Tunisia since 1979. However blood transfusion has remained a cause of malaria transmission in our country. The last Tunisian transfusion induced malaria was diagnosed in 1985 We report two cases of malaria in two transfused patients documented in our laboratory in November 2003. The first case [patient 1] consisted of a Plasmodium falciparum malaria in a bone marrow transplanted patient; the second case [patient 2] was a Plasmodium malaria malaria, following blood transfusion for stomach surgery. Favourable outcome was obtained under intravenous quinine in patient 1, and oral chloroquine in patient 2. In both cases the relation between transfusion and malaria was not obvious. However, anamnesis showed a donor at risk [African origin] in patient 1, whereas the donor could not be identified at all in patient 2. We concluded that systematic screening of donors at risk would be the best way to prevent transfusion induced malaria in Tunisia

[Isosporosis in AIDS, about five Tunisian cases]

Isosporosis is a digestive parasitosis that occurs on a sporadic basis in our country. It is caused by a protozoan of coccidia class: Isospora belli. Between the years 2000 and 2004, five cases of isosporosis were diagnosed in our laboratory in five AIDS patients. Its prevalence among tunisian patients suffering from Human Iminunodeficiency Virus [HIV] infection in our series is about 1.41%. Main clinical manifestations consisted of acute diarrhea, with malabsorption syndrome in one case. Medical management based on specific antibiotics [sulfamethoxazole-trimethoprime], is efficient in avoiding recurrent episodes. However, recurrency remain frequent as long as immunity remains compromised

Les parasitoses digestives chez les manipulateurs de denrees alimentaires

The workers who manipulate foodstuffs and have digestive parasites, represent one potential source of contamination for the consumer. During a period of 6 years, 6092 parasitological examinations of stools are made. The prevalence of digestive parasitism is 14.46%. Entamoeba histolytica and Giardia lamblia represent the half of detected parasites. The authors insist on preventive measures