[Secondary and tertiary prevention of allergic asthma in children]. / Prévention secondaire et tertiaire de l'asthme allergique de l'enfant.

Asthma is a disease of the lung epithelial barrier, most often associated with allergy in children. Asthma and allergy are two distinct diseases, but the phenotypic expression of asthma depends on atopic status. A better definition of phenotypes of asthma would result in better targeting of prevention and treatment modalities. Secondary prevention aims to prevent the onset of asthma and the acquisition of new sensitizations in sensitized children. Studies concerning allergen avoidance are insufficient to reach a definitive conclusion and antihistamines have not been shown to be effective. The results for specific immunotherapy suggest a benefit to prevent transition from allergic rhinitis to asthma and the onset of new sensitizations. Tertiary prevention aims to reduce symptoms in children with an existing allergic asthma diagnosis. The avoidance of known respiratory allergens will only be effective in combination with management of the whole environment. Specific immunotherapy has a real place, in combination with background therapy. It should be used according to guidelines in appropriately treated patients.

[Capnocytophaga sputigena pleuropneumonitis: a case report]. / Pleuropneumopathie àCapnocytophaga sputigena : à propos d'un cas.

Community-acquired pneumonia is complicated by purulent pleural effusion in approximately 28% of affected children. Its incidence has increased over the last decade. Streptococcus pneumoniae is the most frequent causal microorganism, encountered in roughly 80% of cases. We report the case of an immunocompetent 13-year-old teenager wearing orthodontic braces who suffered from pleuropneumonia due to Capnocytophaga sputigena. To date, this Gram-negative bacillus, a commensal of the buccal cavity, had never been reported to be responsible for pleural or lung infection. The clinical presentation is similar to that observed with usual bacteria, while bacterial sensitivity to betalactam antibiotics is excellent.