[Primary lung abscess: unusual situation in child a case report and review of literature]

Lung abscess is a localized area of non tuberculosis suppurative necrosis of the parenchyma of lung, resulting in formation of cavity containing purulent materiel. It is uncommun in child. A 3 years boy was admitted with prolonged fever and dyspnea. Chest X ray showed a thick walled hydric cavitation opacity containing an air-fluid level. Chest ultrasound examination showed collection of 6,8 cm of diameter in the right pulmonary field with an air-fluid level. Hemoculture showed Staphylococcus aureus. Patient presented septic shock and surgical drainage was indicated. Histological examination confirmed diagnosis of lung abscess. Any inderlying condition was noted and diagnosis of primary abscess was made. Patient demonstrated complete recovery. He's asymptoamtic with normal chest X ray and pulmonary function after 3 years of evolution. Lung abscess represent a rare cause of prolonged fever in child. An underlying condition must be excluded to eliminate secondary abscess. Long term follow up of pulmonary function is capital

[Barakat syndrome a report of two cases]

Barakatsyndrome or HDR syndrome [Hypoparathyroidism, sensorineural deafness and renal disease] is an inherited condition. It's a very rare disease. Patients may present with tetany or convulsions due to hypocalcemia at any age. Deafness is usually bilateral and may range from mild to profound impairment. Renal disease has several manifestations. We report the cases of a girl [Ferdaous] and a boy [Taha] which are respectively of 16 years old and 6 years old. The girl only was born of intermarriage. Her brother and sister were treated for hypoparathyroidism. Both of our patients had sensorineural deafness and a nephropathy: a nephrotic syndrome in Ferdaous's case and a proteinury in Taha's case. The girl was treated for hypoparathyroidism since she was 12 while the boy was admitted in emergency for tonico-clonic seizures, reported to a profound hypocalcaemia. Hypoparathyroidism was confirmed by a very low parathormone rate. The endocrinal and cerebral radiological investigations were normal. By this case report, the authors remember the Barakat syndrome: its clinical and biological features, and its different possible progressions. The mode of inheritance is believed to be autosomal dominant. Mutations in the GATA3 gene, mapped to chromosome 10p [gene map locus 10p15, 10p15.1-p14], have been identified in several families with Barakat syndrome. Possibilities of antenatal diagnostic are offered to theses families

[Chronic hepatitis B: a study of 15 cases]

The aim of this study is to describe clinical, biological, histological aspects and outcome of children with chronic hepatitis B [CHB], and to analysis treatment modalities. a retrospective study of 15 children with CHB was conducted between January 1992 and December 2003. All patients had HBs Ag> 6 months, fourteen had Hbe Ag. Initial histological examination was performed in eight cases. intrafamilial horizontal transmission was noted in five cases. Fifty three percent of patients presented symptoms: asthenia [57 percent], anorexia [1 case], loss of weight [1 case], digestive disturbance [3 cases], abdominal pain [5 cases]. Cytolysis was noted in eight patients [53, 3 per cent], they had positive Ag Hbe. Liver emzymes were increased in eight cases [53.3%], they had positive Hbe Ag, mean rate of AST was 95.6 UI/I [extremes: 56 -251], mean rate of ALT was 118,8 Ul/l [extremes: 50 - 204]. Four patients had chronic active hepatitis and four had chronic persistent hepatitis. Three patients received I'interferon a; seroclearance was noted in two patients without negativation of HBs Ag. Twelve patients didn't receive any antiviral therapy, liver emzymes were decreased in three patients, seroclearance of HBe Ag was noted in five cases and HBs Ag elimination was noted in only one patient. Chronic hepatitis B is often asymptomatic and transmitted horizontaly. Antiviral therapy must be indicated in children with viral replication and active chronic hepatitis. Large vaccination at birth reduces vertical transmission and prevalence particularly in endemic areas

[Inaugural diabetic acido-ketosis: rare endocrine complication in thalassemia child]

Diabetes is a sparse endocrine complication of f3 thalassemia major. We report the case of a 14year-old boy with beta thalassemia major, who was polytransfused without regular iron-chelation therapy. He was admitted to hospital with acidosic dyspnoea and severe deshydratation without signs of cardiac failure. Urine examination showed glucosuria and acetonuria. On laboratory exams, glycemia was 39 mmol/l with severe metabolic acidosis. The diagnosis was a diabetic acido-ketosis requiring insulin therapy. Diabetes was hardly controlled; serum ferritin level was 4500 mg/l. Serum ferritin level is the main risk factor for diabetes in patients with beta thalassemia. Thus, an adequate iron-chelation therapy can prevent this complication

[Digeorge syndrome in a new born: DEL22q11.2 IN Tuple1 Locus]

The DiGeorge syndrome is a genetic anomaly due to the microdeletion 22q11.2. This syndrome is characterized by a large variability in the clinical features. In this report we describe a DiGeorge syndrome diagnosed in a new born of a diabetic mother. He presented mild dysmorphia, ventricular septal defect and hypocalcaemia due to hypoparathyroidism. The diagnosis was confirmed by the cytogenetic study

Severe corrosive oesophagitis: are high doses of methyl prednisolone efficient to prevent oesophageal caustic stricture in children?

Corrosive oesophagitis stricture is the long term complication of severe corrosive oesophagitis. The aim of our study was to evaluate the effect of a high doses of steroids on incidence and quality of oesophageal stricture. We reviewed the case histories of 28 children seen at children hospital from 31 December 1991 to 31 December 2001. These children has second and third degree oesophageal burns and they were treated by systemic Methylprednisolone [1000mg/l,73/m2 SC]. The frequency of stricture was 12/26 [46%]. Ten children required a mean of 6,7 [5,74] dilatation range [1 - 17].One patient required an oesocoloplasty. The frequency of stricture in the group treated early before the 24th hour and after the 24th hours was [9/21] [47,4%] versus [3/7] [42,9%]. This difference was not significant [P = 1]. The frequency of stricture in the group treated less than 21 days and more than 21 days was 6/17 [40%] versus 6/9 [66,7%]. This difference was not significant [P = 0,400]. High doses of methyl prednisolone seems to decrease the risk of oesophageal stricture. We found no difference between the children treated before the 24th hours and those treated after the 24 hours and those treated less than 21 days and those more than 21 days