ABSTRACT
INTRODUCTION: Pulmonary actinomycosis due to Actinomyces Odontolyticus is a rare and seldom reported pathology in pediatrics. The unspecific radio-clinical symptomatology and the slow growth of the germ make the diagnosis difficult. CASE REPORT: A 2-year-old boy is admitted to the emergency room for acute respiratory distress in a context of febrile bronchitis that had been evolving for 10days. Quickly, the patient's state deteriorate, invasive ventilation was required. Bronchial fibroscopy was performed immediately and enabled extraction of large mucous filaments, leading to significant improvement. Mechanical ventilation was stopped after 72hours. Five days later, blood culture tested positive for Actinomyces Odontolyticus. In the absence of any other cause and given a compatible clinical picture, the child was treated with long-term antibiotherapy for a total duration of 6months, which was stopped following reassuringly normal endoscopic and radiological control. CONCLUSIONS: This is the second pediatric case of pulmonary actinomycosis due to A. Odontolyticus reported in the literature. The clinical symptoms and imaging are not specific. The presence of sulphide granules on pathological examination or in germ culture at a sterile site confirms the diagnosis. Prolonged antibiotic therapy is still recommended to avoid pulmonary sequels.
Subject(s)
Actinomycosis , Lung Diseases , Actinomyces , Actinomycosis/complications , Actinomycosis/diagnosis , Actinomycosis/therapy , Anti-Bacterial Agents/therapeutic use , Child , Child, Preschool , Humans , Lung/diagnostic imaging , Lung/pathology , Lung Diseases/pathology , MaleABSTRACT
Neuroborreliosis is the second most frequent presentation of Lyme disease in children. Isolated facial palsy is the most classical manifestation of neuroborreliosis, but another clinical picture can be found in children: subacute meningitis, radiculoneuritis, or rarely severe neurological manifestations (transverse myelitis, encephalitis). Diagnosis and treatment guidelines of neuroborreliosis in children will be reviewed here. They are frequently discussed, especially concerning the need for lumbar puncture for diagnosis, and the choice of antibiotic regimen and administration route.
La neuroborréliose est la deuxième présentation la plus fréquente de la maladie de Lyme en pédiatrie. La paralysie faciale isolée en constitue la manifestation la plus classique, mais elle peut également se présenter sous la forme d'un tableau de méningite subaiguë, de radiculonévrite ou, rarement, par des manifestations sévères (encéphalite, myélite). Nous présentons ici les recommandations de diagnostic et de traitement de la neuroborréliose en pédiatrie. Celles-ci font l'objet de discussions fréquentes, notamment concernant la place de la ponction lombaire pour le diagnostic et le choix de la molécule et de la voie d'administration pour le traitement.Résumé non disponible.
