Les brûlures électriques par haut voltage de l'enfant, à propos de trois cas.

High-voltage electrical burn injuries are rare emergencies in pediatric units and always associated with a poor prognosis. Recklessness, lack of knowledge about electric currents and the lack of safety around public electricity infrastructures are the three main factors contributing to the occurrence of high-voltage electrical accidents in children. Mortality is due to acute cardiac and renal complications, and trauma associated with falls. Secondary evolution is dominated by the risk of infection and the severity of functional sequelae. Early diagnosis and prompt treatment is needed to prevent these complications. Therapeutic management is based on early resuscitation and surgical management of tissue damage. We report three cases of high-voltage electrocution in children, with electro-thermal burns associated with severe head injury in one case, and myocardial damage and a compartment syndrome with severe functional sequelae in the other two. These three case reports are an opportunity to discuss literature data.

[Perthes syndrome secondary to an asthma attack: A case report in a 15-year-old child]. / Syndrome de Perthes secondaire à une crise d'asthme : à propos d'un cas chez un enfant de 15 ans.

Perthes syndrome, or traumatic asphyxia syndrome, is a rare clinical entity, associating cyanosis, cervicofacial petechiae and subconjunctival hemorrhage. It is usually secondary to chest trauma, but can occur in any situation of abrupt rise in intrathoracic pressure with closed glottis. In this paper, we present a case of Perthes syndrome that triggered an asthma attack for a child during surgery.

A comparison of human metapneumovirus and respiratory syncytial virus WHO-defined severe pneumonia in Moroccan children.

Acute respiratory infections remain the principal cause of morbidity and mortality in Moroccan children. Besides bacterial infections, respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are prominent among other viruses due to their high prevalence and association with severe clinical episodes. We aimed to describe and compare RSV- and hMPV-associated cases of WHO-defined severe pneumonia in a paediatric population admitted to Morocco's reference hospital. Children aged 2-59 months admitted to the Hôpital d'Enfants de Rabat, Morocco meeting WHO-defined severe pneumonia criteria were recruited during 14 months and thoroughly investigated to ascertain a definitive diagnosis. Viral prevalence of RSV, hMPV and other viruses causing respiratory symptoms was investigated in nasopharyngeal aspirate samples through the use of molecular methods. Of the 683 children recruited and included in the final analysis, 61/683 (8·9%) and 124/683 (18·2%) were infected with hMPV and RSV, respectively. Besides a borderline significant tendency for higher age in hMPV cases, patients infected with either of the viruses behaved similarly in terms of demographics, patient history, past morbidity and comorbidity, vaccination history, socioeconomic background and family environment. Clinical presentation on arrival was also similar for both viruses, but hMPV cases were associated with more severity than RSV cases, had a higher risk of intensive care need, and received antibiotic treatment more frequently. RSV and hMPV are common and potentially life-threatening causes of WHO-defined pneumonia in Moroccan children. Both viruses show indistinctive clinical symptomatology, but in Moroccan children, hMPV was associated with a more severe evolution.

[Esophageal foreign body revealed by respiratory distress]. / Détresse respiratoire révélant un corps étranger œsophagien méconnu.

Ingestion of a foreign body is usually accidental in children. Respiratory symptoms, often favored by the persistence of the foreign body in the esophagus, can be revealing, but rarely respiratory distress as a method telling. We report a case of unrecognized esophageal foreign body revealed by respiratory distress.

[Severe tetanus complicated with rhabdomyolysis and acute renal failure: a pediatric case report]. / Tétanos grave compliqué de rhabdomyolyse et d'insuffisance rénale : à propos d'une observation pédiatrique.

Renal failure is a rare complication of tetanus in children. It occurs following poorly controlled muscle spasms and rigidity. We describe a severe case of tetanus complicated with rhabdomyolysis and acute renal failure in a child.

[Spontaneous intracerebral haemorrhage secondary to congenital factor XIII deficiency]. / Hémorragie intracérébrale spontanée secondaire à un déficit congénital en facteur XIII.

Deficiency of coagulation factor XIII is a rare anomaly. The risk of intracranial haemorrhage is particularly high at any age, either spontaneously or during minor trauma. We report a case of spontaneous intracerebral haemorrhage in a child carrying a known deficiency of factor XIII.

[Traumatic asphyxia or Perthe's syndrome. About two paediatric cases]. / Syndrome d'asphyxie traumatique ou syndrome de Perthes: à propos de deux observations pédiatriques.

The traumatic asphyxia or Perthes' syndrome is a condition characterized by a classic triad involving head and neck cyanosis, subconjonctival bleeding, and petechiae. The pathophysiology of traumatic asphyxia is different in children compared to adults, because of the greater elasticity of the thorax in children. The purpose of this paper is to describe through two cases of traumatic asphyxia in young children the characteristics of this disease in children.

[Rigid bronchoscopy for pin extraction in children at the Children's Hospital in Rabat, Morocco]. / Bronchoscopie rigide pour extraction d'épingle chez l'enfant à l'hôpital d'enfants de Rabat, Maroc.

PURPOSE: The aim of this work is to present the clinical and therapeutic aspects of pin inhalation in the airways, as well as the benefit of rigid bronchoscopy for extraction in children. MATERIALS AND METHODS: Five hundred and twenty-four cases of inhaled foreign body are identified in the multipurpose pediatric intensive care unit in the children's hospital in Rabat between January 2005 and December 2010. Thirty-six (6.8%) of them are due to pin inhalation. A retrospective study was conducted to define the epidemiological characteristics, clinical treatment and outcome of pin inhalation in the airways. RESULTS: Thirty-six cases of pin inhalation are identified, all females. The age varies from 10 to 15 years. The consultation period is 2 days. Symptoms are dominated by coughing and stinging sensation. In 61.11% (22 cases), the pin is lodged in the right airways, in 22.22% (eight cases) in the left airways and in 5.5% (two cases) at the trachea. In 63.8% (23 cases), the pin is removed at the first attempt. We did not record any severe complications. No deaths recorded. CONCLUSION: Pin inhalation is a common occurrence in young girls. The extraction can be done safely by rigid bronchoscopy under general anesthesia. Particular attention should be paid to prevention and educational programs to reduce the incidence of pin inhalation.

[Anaphylactic shock in surgery of liver hydatid cyst in children: a case report]. / Choc anaphylactique au cours de la chirurgie du kyste hydatique du foie chez l'enfant : à propos d'un cas.

The hydatid disease is common and remains endemic in Morocco. The treatment relies mainly on surgery. This may be accompanied by rare but serious complications that can certainly be life-threatening. Allergic reactions can manifest as anaphylactic shock which is characterized by its brutal onset and its severity. We stress through the pediatric case reported the exceptional occurrence of anaphylactic shock during surgery and the need for its early recognition in order to establish effective treatment. Prevention relies mainly on surgical precautions taken to avoid seeding of the abdominal cavity.

[Epidemiology of envenomation by snakebite in pediatric intensive care unit at Children's hospital of Rabat, Morocco]. / Épidémiologie des envenimations par morsure de vipère en unité de réanimation pédiatrique à l'hôpital d'Enfants de Rabat au Maroc.

The snakebite is the most severe form of envenomation. The aim of this retrospective study was to describe the epidemiological, diagnostic, therapeutic and evolutionary snakebites in Children in paediatric intensive care unit of the children's hospital of Rabat. The criteria of severity were studied in four grades : grade 0 (traces of hooks at the bite, no swelling or local reaction), grade 1 (local oedema, absence of constitutional symptoms), grade 2 (swelling of regional member and/or moderate symptoms), grade 3 (extensive swelling up the trunk and/or severe symptoms). The number of patients included was 17 between January 2004 and December 2009. The male predominance (59%), bites by snakes (76%), bites during the afternoons (76%) and summer (53%), bites to the lower limb (65%) were net, corroborating the data from the literature on the subject. The median period of treatment was 9.5 hours, 53% of cases of severe grade 2 and 3 versus 47% in grades 0 and 1. The median duration of hospitalization was five days. One child died (6%). No child received antivenin treatment. Our analysis calls for the availability of specific immunotherapy in local health institutions in high-risk areas, such as ours.

[Prevalence of allergic rhinitis in a rural area of Settat, Morocco]. / Prévalence de la rhinite allergique en milieu rural à Settat (Maroc).

We evaluated the prevalence of allergic rhinitis in a rural population of Settat and its relationship with intestinal parasitosis and living conditions. The sample comprised 336 subjects living in 3 clusters. Rhinitis was evaluated using the ISAAC questionnaire. Prevalence of rhinitis was 37.8%. It was higher in those aged 15-49 years, illiterate subjects, active smokers, those presenting with overweight and those with hypereosinophilia. It was significantly lower in children < 10 years. Rhinitis was associated with sibship size and literacy, but not with intestinal parasitosis and helminth infections.

[Prevalence of allergic rhinitis in a rural area of Settat, Morocco]

We evaluated the prevalence of allergic rhinitis in a rural population of Settat and its relationship with intestinal parasitosis and living conditions. The sample comprised 336 subjects living in 3 clusters. Rhinitis was evaluated using the ISAAC questionnaire. Prevalence of rhinitis was 37.8%. It was higher in those aged 15-49 years, illiterate subjects, active smokers, those presenting with overweight and those with hypereosinophilia. It was significantly lower in children < 10 years. Rhinitis was associated with sibship size and literacy, but not with intestinal parasitosis and helminth infections

Intestinal parasitosis and use of untreated wastewater for agriculture in Settat, Morocco.

An evaluation was made of the risk of contamination by faecal parasites in the population from the use of wastewater in agriculture. The study was based in 3 rural clusters in the northern region of Settat city, Morocco: 2 rural clusters exposed to untreated wastewater in agriculture and 1 not exposed. The sample comprised 333 people aged 3-60+ years: 214 exposed and 119 non-exposed. Stool samples were collected and examined for intestinal parasites. The results showed that the prevalence of intestinal parasitosis (i.e. evidence of at least 1 type of parasite) in the exposed group was significantly higher that the non-exposed group (66.4% versus 31.9%; relative risk 2.1). The household crowding index was also higher in the exposed group.

Intestinal parasitosis and use of untreated wastewater for agriculture in Settat, Morocco

An evaluation was made of the risk of contamination by faecal parasites in the population from the use of wastewater in agriculture. The study was based in 3 rural clusters in the northern region of Settat city, Morocco: 2 rural clusters exposed to untreated wastewater in agriculture and 1 not exposed. The sample comprised 333 people aged 3-60+ years: 214 exposed and 119 non-exposed. Stool samples were collected and examined for intestinal parasites. The results showed that the prevalence of intestinal parasitosis [i.e. evidence of at least 1 type of parasite] in the exposed group was significantly higher that the non-exposed group [66.4% versus 31.9%; relative risk 2.1]. The household crowding index was also higher in the exposed group

[Prevalence of Giardia intestinalis in a farming population using sewage water in agriculture, Settat, Morocco]. / Prévalence de Giardia intestinalis chez une population rurale utilisant les eaux usées à des fins agricoles à Settat, Maroc.

OBJECTIVE: This investigation was undertaken to assess the risk linked to the use of raw sewage waters in agriculture, and the prevalence of Giardia intestinalis. DESIGN: The survey was made on 214 individuals, average age 28.6+/-19.4 years, belonging to two douars using raw sewage waters in agriculture, and 119 individuals, age 31.8+/-19.5 years, belonging to a control douar not using raw sewage waters. These three douars are located in around the city of Settat, in Morocco. Every consenting individual was given a complete clinical examination and 3 stools samples were collected in 3 consecutive days. RESULTS: The prevalence of G. intestinalis in the exposed population was 11.7% compared to 2.5% in the control population. The relative risk was 4.6. This difference is statistically significant. The most concerned individuals were essentially children between 3 and 14 years of age. Close contact was an important factor of infection in the exposed population, with a higher prevalence in the case of high promiscuity index. In the exposed population, more than 50% of the cases were familial ones. Giardiasis causes a trophic state, essentially in children. CONCLUSION: The use of the raw sewage waters in agriculture is responsible for an increased risk of giardiasis. Some preventive measures are mandatory, including hygiene education and an adequate treatment of sewage waters.