Subject(s)
Hyperargininemia , Metabolism, Inborn Errors/diet therapy , Child, Preschool , Humans , InfantABSTRACT
BACKGROUND: Chickenpox encephalitis is usually mild and often presents as an acute cerebellar ataxia. Seizures and coma are uncommon. CASE REPORT: A 4-year old girl presented generalized seizures. Two days after the onset of chickenpox, she developed ataxia and left hemiparesis on day 3, followed by left hemiplegia after 24 hours. The cerebral scan showed areas of subcortical hypodensity compatible with leuko-encephalitis. The EEG showed lesions of acute leuko-encephalitis located in the right sub-cortical temporo-fronto-parietal area. The patient was given cortico-steroid and recovered slowly but completely. CONCLUSIONS: Hemiplegia, an exceptional event during the course of chickenpox, makes the diagnosis of chickenpox leuko-encephalitis difficult; IRM appears to be a contributing factor.
Subject(s)
Chickenpox/complications , Encephalitis, Viral/etiology , Hemiplegia/etiology , Brain/pathology , Child, Preschool , Encephalitis, Viral/drug therapy , Encephalitis, Viral/pathology , Female , Hemiplegia/drug therapy , Hemiplegia/pathology , Humans , Magnetic Resonance Imaging , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: About 60-70% of cases of anaphylactoid purpura suffer from abdominal colic, which may be quite severe. Because severe abdominal pain may be difficult to differentiate from a surgical abdomen, repeated examination and radiological studies are often necessary. CASE REPORT: A 4 year 7 month-old girl suffered from abdominal pain, vomiting and the skin rash characteristic of anaphylactoid purpura. Because of worsening of the abdominal manifestations, a Gastrografin enema was given. The result was normal but 48 hours later, the child suffered from acute abdominal colics plus symptoms of shock. X-ray examination revealed a large distension of colon and persistence of the contrast material. Exploratory laparotomy failed to find any perforation or necrosis. The colon was drained and the child was given parenteral nutrition and antibiotics. Blood culture showed Klebsiella pneumoniae. An upper gastrointestinal roentgenogram using meglumine ioxitalamate was performed 19 days later because of recurrence of the abdominal pain. This showed a submucosal hemorrhage in the first small bowel loop. Increased abdominal distension occurred 3 days later and the results of X-rays were similar to those seen the Gastrografin enema. A second enema using meglumine ioxitalamate was performed 3 days later. It showed sigmoid constriction but a second laparotomy failed to confirm this obstruction. The child died a few hours later despite ileostomy and antibiotics. CONCLUSIONS: The severe colectasy seen in this case of anaphylactoid purpura indicates that caution is required in performing enemas in acute digestive complications of this disease. Such X-ray studies should not be repeated and all water-soluble contrast material should be voided as soon as possible.
Subject(s)
Colonic Diseases/chemically induced , Contrast Media/adverse effects , IgA Vasculitis/complications , Child, Preschool , Colonic Diseases/complications , Enema , Female , Humans , IgA Vasculitis/diagnostic imaging , Radiography , SolubilityABSTRACT
A survey by questionnaire was carried out among pediatricians of the departments of pediatrics of the non university hospitals in France in order to know the activity and the conditions of work of these departments. Responses were obtained from 84 of the 140 departments of pediatrics. The results emphasized the important activity of these departments contrasting with frequent insufficiencies of the medical staff and equipment. Solutions are proposed in order to avoid an aggravation of the actual situation.
Subject(s)
Hospital Departments/trends , Pediatrics , Forecasting , France , Hospital Bed Capacity , Hospital Departments/statistics & numerical data , WorkforceABSTRACT
Association of congenital adrenal hyperplasia (21 hydroxylase deficiency) and hemophilia A in one child is reported; the authors insist about the rarity and the genetic implications of this association in case of other children.
Subject(s)
Adrenal Hyperplasia, Congenital , Adrenal Hyperplasia, Congenital/complications , Hemophilia A/complications , Steroid Hydroxylases/deficiency , Adrenal Hyperplasia, Congenital/etiology , Adrenal Hyperplasia, Congenital/genetics , Hemophilia A/genetics , Humans , Infant, Newborn , MaleABSTRACT
From the retrospective study of 141 children suffering from mucous otitis requiring drainage, the percentage of 40% perinatal factors (birth by cesareans, prematurity, neonatal intensive care) has been found much higher than in the general population. This suggests: 1. that there is, under these conditions, a deficiency of ventilation of the middle ear linked to a pathology of the "surfactant", and/or to a poor resorption of the intra-auricular fluid and mesenchyma of the drum of the ear; 2. that preventive measures should be taken in this high risk population, consisting of systematic ear examinations with pneumo-otoscopy during compulsory health examinations and tympanometry if an abnormality of the ear drum is found.
Subject(s)
Delivery, Obstetric/methods , Infant, Newborn, Diseases , Otitis Media with Effusion/etiology , Child, Preschool , Critical Care , Drainage , Female , Humans , Infant , Infant, Newborn , Infant, Premature, Diseases , Pregnancy , Retrospective Studies , RiskABSTRACT
Long duration continuous recording of esophageal pH was performed in 20 children suspected of having gastroesophageal reflux. Six pH monitoring parameters were analysed and their values compared with normal standards found in the literature. The results of pH monitoring were compared with those of upper gastrointestinal series and with oesophagoscopy, performed in all patients but one. The diagnostic utility of long duration pH monitoring is discussed, according to data in the literature.
