Tropheryma whipplei associated with diarrhoea in young children.

Tropheryma whipplei was detected in preliminary studies in faeces of young children with diarrhoea and also in faeces of asymptomatic persons, not only in Europe but also in Africa. In this study, the link between this bacterium and the presence of acute diarrhoea was evaluated in a large group of children. From December 2009 to January 2013, rectal swabs collected from 3796 children in the emergency departments of university hospitals in Marseille, France, were analysed: 555 children (245 female and 310 male, from 6 days to 6 years old) with acute diarrhoea defined as at least three loose stools per day for <1 week and 3241 children (1444 female and 1797 male, from 22 days to 6 years old) without diarrhoea. Specific quantitative real-time PCR was performed to detect the presence of T. whipplei and of two enteric pathogens Clostridium difficile and Giardia duodenalis. Tropheryma whipplei was significantly more common in children with diarrhoea (22/555, 4%) than without (56/3241, 1.7%; p 0.001). Neither C. difficile nor G. duodenalis showed this association. For C. difficile, 39 of 531 (7.3%) children with diarrhoea were positive versus 184 of 3119 (5.9%) of children without diarrhoea (p 0.25). For G. duodenalis, 2 of 529 (0.37%) children with diarrhoea were positive versus 5 of 3119 (0.16%) children without diarrhoea (p 0.26). Tropheryma whipplei was found more commonly in autumn. Tropheryma whipplei is significantly associated with diarrhoea in children, suggesting that the bacterium may be a cause of acute diarrhoea.

[Epidemiology of Streptococcus pyogenes infections in developing countries]. / Épidémiologie des infections à streptocoque du groupe A dans les pays en développement.

Group A streptococcal (GAS) infections are frequent in developing countries but the epidemiology is incompletely known. In 2005, 90 % of symptomatic pharyngitis, 96 % of invasive diseases and 97 % of deaths due to GAS were observed in these countries. Clinical features of GAS invasive infections are identical to those reported in developed countries, but frequency and mortality are higher, as is the number of the different emm types involved. In the world, from 15.6 to 19.6 millions of persons are affected by rheumatic heart disease (282,000 new cases and 233,000-468,000 deaths per year). Incidence of acute post-streptococcal glomerulonephritis varies with time and location: in 2005, 472,000 new cases have been reported in the world (83 % in a developing country). World Heart Federation recently aimed at reducing the burden of rheumatic heart diseases by 25 % among < 25 years persons in 2025.

[Passive cocaine inhalation by a 25-month-old child]. / Intoxication passive à la cocaïne d'un enfant de 25 mois.

Cocaine and its principal metabolite were isolated from the urine, confirmed by urine chromatographic analysis, in a 25-month-old girl who had unsteady gait and a third fever seizure. She was premature, had intrauterine growth restriction (IUGR), and a psychomotor delay. The hair examination confirmed prolonged cocaine exposure. The concentration was significant and showed that she had been intoxicated for the 10 previous months. Passive cocaine inhalation may have caused and contributed to these symptoms.