[Chronic aqueous diarrhea in children: An unusual etiology]

Peripheral neuroblastic tumors are the most common extracranial solid tumors in children. On the other hand, diarrheal neuroblastic tumors are quite rare and not easy to diagnose in the early stage. We report a case of neuroblastic tumor in a 2-year old girl presenting with aqueous diarrhea caused by paraneoplasic secretion of VIP.

Cryptosporidiosis and microsporidiosis as causes of diarrhea in kidney and/or pancreas transplant recipients

INTRODUCTION

Gastrointestinal disorders in solid organ recipients may have various origins including cryptosporidiosis and microsporidiosis. The prevalence of these infections is poorly known in solid organ transplant (SOT) patients in industrialized countries.

METHODS

We prospectively assessed the infectious causes of diarrhea in SOT patients. Secondary objectives were to gain further insight into the main characteristics of cryptosporidiosis, and to assess risk factors for this infection. All adult kidney and/or pancreas recipients presenting with diarrhea and admitted to our facility between May 1, 2014 and June 30, 2015 were enrolled. A stool sample was analyzed using a standardized protocol including bacteriological, virological, and parasitological investigations. Data related to clinical symptoms, immunosuppression, and environmental potential risk factors were collected through a self-administered questionnaire and computerized medical records.

RESULTS

Out of 73 enrolled patients, 36 had infectious diarrhea (49.3%). Viruses ranked first (17/36), followed by parasites and fungi (11/17). Cryptosporidiosis was the most common parasitic disease (n=6 patients). We observed four microsporidiosis cases. The estimated prevalence of cryptosporidiosis and microsporidiosis in this cohort was 3.7 and 2.4⁰/₀₀, respectively_. No significant risk factor for cryptosporidiosis or microsporidiosis, neither environmental nor immunological, could be evidenced.

CONCLUSION

Both cryptosporidiosis and microsporidiosis represent a significant cause of diarrhea in kidney transplant recipients.

[Large bowel ganglioneuromatosis associated with neurofibromatosis type 1]

Gastrointestinal tract ganglioneuromatosis is a rare condition, which is isolated or included in a syndromique disease. Multiple endocrine neoplasia type 2 is the most frequently associated syndrome. Association with type 1 neurofibromatosis has also been established, but much rarely. We report the case of large bowel ganglioneuromatosis found incidentally in a patient with type 1 neurofibromatosis.

[Supporting factors of diarrhoea diseases in the children under 5 years in Commune II of the district of Bamako- Mali]

Diarrhea remains a real public health problem as it is the second leading cause of under-five mortality. In tropical environments, studies show several factors contributing to the frequency and severity of diarrhea. It is in this context that the present study of the factors favoring diarrheal diseases in children from 0 to 5 years old has been carried out.

MATERIALS AND METHODS

Cross-sectional cluster survey involving 200 mothers of 0-5 year-old children from November 2015 to October 2016. The Pearson Chi² test was used with a 95% confidence level.

RESULTS

Married women accounted for 85.5% of our sample, 47% of whom had no education. Of the mothers surveyed, 17% of their children had had at least one episode of diarrhea in the two weeks before the survey. Almost all mothers (94%) washed their hands before feeding their children and 13% did not do so after cleaning the children. Regarding the cleanliness of the concession, it was bad in 23.5%. The majority of mothers (51%) did not know the significance of diarrhea, 43% reported the means of transmission, and 28% had inadequate practice in managing diarrhea. Some factors favor the occurrence of diarrhea such as: mixed breastfeeding that was statistically significant (p = 0.014), as well as poor hand hygiene practices (p = 0.027) and concessions (p = 0.000), as well as than the bad knowledge of the subject (p = 0.000).

CONCLUSION

Our study shows that diarrhea was a disease of the hands rooms, hence the interest of strengthening the awareness of mothers for best practices for behavior change.