[Marginal Féréol-Besnier erythema: rare manifestation during acute articular rhumatism]. / Erythème marginé de Besnier: manifestation rare au cours du rhumatisme articulaire aigu.

This study reports the case of a 3-year old female child with a 1-year history of rash manifesting as discoid plaques with pink, non-itchy, rounded and oval, polycyclic, confluent macular areas measuring 1-3 cm in diameter, with central clearing evolving in stages, with repeated regression and reappearance. The child was admitted to the Emergency Department with respiratory distress, fever and aggravation of pre-existing skin lesions becoming diffuse. Mitral holosystolic murmur with an intensity of grade 4/6 was recorded by cardiac auscultation. Cardiac ultrasound showed acute massive mitral insufficiency with valvular vegetations. Laboratory tests showed inflammation with a CRP level of 300 mg/l and a sedimentation rate of 60 mm in the first hour and ASLO levels were very high (1600 IU/ml). The diagnosis of infectious endocarditis due to valvular rheumatic heart disease was retained. After stabilization, antibiotic therapy and mitral valve surgery in emergency, the dermatological lesions regressed in a few days but the haemodynamic condition of the child deteriorated rapidly with sudden death. Besnier erythema is a rare cutaneous manifestation of acute articular rhumatism. Physicians should not neglect this rare but useful clinical sign, especially in patients with subclinical valvular involvement in order to avoid potential late cardiac complications. The three differential diagnoses included: ringworm, urticaria, and erythema due to hereditary angioedema.

The pharmacist's role in managing and ameliorating childhood's asthma care: a descriptive and transversal study about 104 pharmacists in the city of Rabat in Morocco.

This work aims at enhancing the management of childhood asthma, with a focus on pharmacists in particular, by evaluating their knowledge of childhood asthma and assessing their attitude while they are providing asthma medicines. Consequently, it will look at the necessity of introducing training days about childhood asthma for pharmacists. This is a transversal and descriptive study which lingered from August to October 2015. Data has been collected using a questionnaire that was self-administered to every surveyed pharmacist in the city of Rabat. The 104 pharmacists who replied to the questionnaire have an average general understanding about asthma and its treatment. Only a quarter of them managed an asthma crisis in their pharmacy before directing the child to the emergency. 50% of them do not know the difference between the basic asthma therapy and the asthma attack therapy. However, all of them recommended the parents to see a physician regarding their child's asthma. 75% advise the systematic use of an asthma spacer with the inhaler. 87.5% of them give advice to parents regarding the good measures for environmental control, and 98% estimate that the therapeutic education is important in childhood asthma management. 88.5% among them are interested in training days about childhood asthma.This study shows the necessity of further pharmacists' education about asthma and its management.

[Ophthalmic zoster: an uncommon dermatosis in infants]. / Le zona ophtalmique: une dermatose exceptionnelle chez le nourrisson.

We here report the case of a 9-month infant, born to a mother with a history of varicella in the third trimester of pregnancy but with no history of atopy, admitted to the emergency room with painful, pruritic rash in the right hemiface that had been ongoing for 4 days. During physical examination, the infant appeared to be in pain, with multiple cluster of grouped vesicles on erythematous skin in the right hemiforehead, in the right side of the nose and in the right cheek associated with edema of the upper and lower eyelids, with difficulty opening eyes and purulent conjunctival secretions. The infant was afebrile and in a good general condition. Ophthalmologic examination using the slit-lamp and fundus examination were normal. Complete blood count was normal. The diagnosis of ophthalmic zoster was retained on the basis of the clinical appearance of the lesions. The infant was treated with intravenous Aciclovir for 10 days associated with symptomatic local antiseptic treatment. Patient's evolution was marked by the regression of vesicular lesions and of edema. Viral serologic test and rapid HIV test were negative. The particularity of our study is the occurrence of ophthalmic zoster in an immunocompetent infant, which is rare in children. We made three differential diagnoses which included Kaposi-Juliusberg syndrome, cutaneous infection due to herpes simplex virus and facial erysipelas.

A three-year-old boy with hypodipsic hypernatremia syndrome.

We describe a three-year-old boy who had a growth and psychomotor retardation associated with inappropriate lack of thirst and vasopressin secretion in the presence of chronic plasma hyperosmolarity. Computed brain tomography revealed bilateral supratentorial sub-ependymal and cortical calcifications. Dissociation in the plasma vasopressin response to osmotic change was demonstrated in this patient. Treatment with a vasopressin analogue, desamino-D-arginine vasopressin (DDAVP) and forced intake of water restored plasma osmolality and serum sodium levels to normal.

[Hepatic hematoma in neonates: about a case]. / Hématome hépatique néonatal: à propos d'un cas.

Hepatic hematoma is a condition of unrecognized origin which can become extremely serious and whose diagnosis is often made during perinatal autopsy. It is often characterised by nonspecific clinical manifestations and a long delay before biological presentation.The diagnosis is essentially based on ultrasound and treatment is often conservative.We here report a case of a full-term newborn with asymptomatic hepatic haematoma due to obstetrical trauma.