Résumé
Discovered since 1930, the CRP knows an actual regain of interest because of a better knowledge of its bilogic functions and progress in its technic dosage [immunoturbidimetry, immunonephelometry.] wich lead to a rapid dosage [15 min] quantitative and sensitive result which required only a few blood drops obtained by a simple puncture of a finger edge or heel wich is important in Pediatric. A high level of CRP enable the practician to predict a bacterial infection. The fact that it doesn't cross over the placentea barrier gives it a great interest during the neo-natal period. Due to its cinetic it leads to an early diagnosis and accurate supervision. A very high level can have a predictive value of sequelaes developement. In the case of favorable evolution the plasmatic level decrease 24h before fever decrease. If the level remains high dispite the treatment, the antibiotherapy is not effective. The level decreasing followed by an increasing means complication. The CRP dosage is indicated in the diagnosis and supervision of neo-natal infection, miningitis and tract urinary infection. It has not any practic interest in acute respiratrory infection and practically no interest in gastro-enteritis
Sujets)
Humains , Maladies transmissibles , Cytokines , Sédimentation du sang , Infections urinaires , Gastroentérite , Infections de l'appareil respiratoireRésumé
The immunodepression states include varied pathology. The vaccinal recommandations concern particularly cases of agamma-globulinemia and acquired immunodepression. In france, the classical contre-indications were reprecised [circular 706 of 27-12-85]. The pathological situations are different for each state of immonodepression, however it should always face three questions in immnonodepressed infant: 1- Danger or safety of vaccine [Tolerance] = 2- Immunogenecity of vaccine during a disease or immonodepressor treatment = 3- Evolution of antibodies acquired by vaccination before the disease and before the immonodepressor treatment = . The children born from mothers infected by Hiv should be vaccined as soon as possible in non symptomatic stage, the vaccination by active vaccines [BCG, Measles] must be discussed in specialised pediatric team. The studies concerning the vaccinations of children under chemiotherapy are rare and faling sometimes contradiction results. At the admission of a child in an oncology service, the antibodies dosage and the vaccinal program must be dose with precision. The correct protection of his or her clase brothers and sisters is indispensable so as to reduce the risk of contamination particularly by Measles and chicken pox. It seems that six months is an acceptable delay between an immunodepressor treatment and the administration of active vaccine. Neither dead vaccines or active vaccines are contra-indicated in case of a short term or entertaining corticotherapy without a disease of immunity and in case of local corticotherapy. High dose and long-term corticotherapy contra-indicated active vaccines. The pneumococcinal vaccination is recommended in splenectomised child. The vaccine anti-hamophilus b must be associated to 23 pneumo vaccine in child with drepanocytosis