1
|
Aoun N, Nader L, Haddad-Zebouni S, Ghossain M, Akatcherian C. Infarctus segmentaire gauche du grand épiploon chez l'enfant : traitement conservateur. Arch Pediatr 2006; 13:1040-2. [PMID: 16647251 DOI: 10.1016/j.arcped.2006.02.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2005] [Accepted: 02/13/2006] [Indexed: 11/30/2022]
Abstract
Omental infarction is a rare cause of acute abdomen that usually occurs on the right side. Left omental ischemia is rare in adults and to our knowledge not yet described in children. Its diagnosis, although difficult, is important because it can avoid surgery. We report a case of left segmental omental infarction in an 11-year-old child, diagnosed by imaging studies, treated conservatively, and followed up by ultrasound until complete disappearance of the lesion.
Collapse
Affiliation(s)
- N Aoun
- Service d'imagerie médicale, Hôtel-Dieu-de-France, boulevard Alfred-Naccache, Achrafieh, Beyrouth, Liban
| | | | | | | | | |
Collapse
|
2
|
Affiliation(s)
- P Cochat
- Département de pédiatrie, hôpital Edouard-Herriot, 5, place d'Arsonval, 69437 Lyon cedex 03, France; Université Claude-Bernard, Lyon, France.
| | | | | | | | | | | |
Collapse
|
3
|
Akatcherian C. La pédiatrie dans les pays en conflit. L'enfant victime de la guerre. Arch Pediatr 2005; 12:869-70. [PMID: 15904833 DOI: 10.1016/j.arcped.2005.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- C Akatcherian
- Département de pédiatrie, université Saint-Joseph, Hôtel-Dieu-de-France, Beyrouth, Liban
| |
Collapse
|
4
|
|
5
|
Haddad-Zebouni S, Zafatayeff-Hasbani S, Aoun N, Akatcherian C. [Adrenal hematoma associated with rheumatoid purpura]. Arch Pediatr 2002; 9:274-7. [PMID: 11938540 DOI: 10.1016/s0929-693x(01)00765-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
UNLABELLED Schönlein-Henoch purpura is a systemic vasculitis involving primarily the skin, musculoskeletal system, gastro-intestinal tract, and kidneys. The purpose of this paper was to report the first described pediatric case, to our knowledge, of adrenal hemorrhage occurring in Schönlein-Henoch purpura. CASE REPORT Our patient was a 12 year-old girl who presented a right adrenal hematoma diagnosed following an episode of acute right flank pain, ten days prior to the appearance of the clinical symptoms of Schönlein-Henoch purpura. CONCLUSION We think that Schönlein-Henoch purpura should be included in the diagnosis of adrenal hematomas.
Collapse
Affiliation(s)
- S Haddad-Zebouni
- Département d'imagerie médicale, Hôtel-Dieu de France, rue Alfred-Naccache, Beyrouth, Liban.
| | | | | | | |
Collapse
|
6
|
Abstract
PURPOSE To evaluate the efficacy of vigabatrin (VGB) in the treatment of infantile spasms (ISs) associated with Down syndrome (DS) and to assess the feasibility of early discontinuation to reduce the possible retinal toxicity. METHODS Five children with ISs with DS were treated with vigabatrin as first-line monotherapy in an open prospective study. The short-term response was evaluated, and VGB was continued in responders. The treatment was stopped after 6 months in children who were still spasm free. RESULTS Four children of five became spasm free with VGB, three of them responding within 1 week. This response was maintained during the 6 months of VGB treatment. After VGB discontinuation, and with a follow-up ranging from 2 to 4 years, none of the responders experienced spasm recurrence or other types of seizures. CONCLUSIONS This study confirms the efficacy of VGB in ISs associated with DS. Moreover, it shows that the duration of VGB treatment can be reduced to 6 months without relapse of ISs. This short treatment might reduce the risk of developing visual field constriction.
Collapse
Affiliation(s)
- R Nabbout
- Department of Pediatrics, Hôpital Hôtel Dieu de France, Université St. Joseph, Beirut, Lebanon
| | | | | | | | | |
Collapse
|
7
|
Abstract
Congenital brain tumors are very rare; their incidence is estimated at 0.34 per million live births. We report a case of congenital gliosarcoma in a neonate conceived by in vitro fertilization (IVF). One other case of brain tumor (medulloblastoma) is reported in a child born after assisted conception. Whether these tumors are causally related to the IVF remains obscure.
Collapse
Affiliation(s)
- T Rizk
- Department of Neurosurgery and Neurology, Hôtel Dieu de France Hospital, Beirut, Lebanon.
| | | | | | | |
Collapse
|
8
|
Gerbaka B, Akatcherian R, Hage G, Melki I, Nuwayhid I, Saab B, Akatcherian C. [Prevention of accidents on public roads in children in Lebanon. Is there a path to follow?]. Arch Pediatr 2000; 6 Suppl 2:315s-316s. [PMID: 10370520 DOI: 10.1016/s0929-693x(99)80452-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- B Gerbaka
- Département de pédiatrie, Faculté de médecine, Université Saint-Joseph, Liban
| | | | | | | | | | | | | |
Collapse
|
9
|
Mikhael R, Gerbaka B, Melki I, Akatcherian C, Naman R. [Familial lymphohistiocytosis. Evolution of management apropos of 3 cases]. J Med Liban 2000; 48:100-3. [PMID: 11028159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Familial lymphohistiocytosis is a rare rapidly lethal genetic disease. It is characterized by an uncontrolled activation of T lymphocytes and macrophages, with multiple organ infiltration, beginning with fever and unexplained coagulopathy. Recently, one of the genes implicated in 50% of families at risk was identified (locus FHL1, chromosome 10, region q21-22). Based on data suggesting an essential role of T lymphocytes in the genesis of familial lymphohistiocytosis, the treatment has recently evolved from a chemotherapy including Etoposide (VP16) and corticosteroids, sometimes efficient but toxic, to an almost always efficient and slightly toxic immunosuppressive treatment. These two treatments achieved a remission somewhat lasting with no definite cure. In fact, all patients relapsed in the central nervous system and died. Bone marrow transplantation (BMT) is the only curative treatment. However only 20% of patients benefit from an HLA identical BMT. Recent improvements in HLA non-identical BMT offer an acceptable alternative to the other 80% of patients. In this review, we present three cases illustrating the evolution and optimization in the management of infants with familial lymphohistiocytosis.
Collapse
Affiliation(s)
- R Mikhael
- Département de pédiatrie, Hôtel-Dieu de France (HDF), Université Saint-Joseph (USJ), Beyrouth, Liban.
| | | | | | | | | |
Collapse
|
10
|
Mourani C, Kfouri W, Mallat S, Afiouni N, Ghobril R, Kassouf J, Abboud S, Karam J, Alame H, Manader A, Akatcherian C. [Multicenter study of children with terminal renal failure in Lebanon]. J Med Liban 1999; 47:309-12. [PMID: 10887536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/14/2023]
Abstract
A retrospective study was conducted in June 1997 concerning all Lebanese children with end stage renal failure. This study was able to recognize 20 children and infants (age less than 15) dialysed regularly in 8 hemodialysis centers. The other 23 centers are not following children. Thirteen children are dialysed on bicarbonate and seven on acetate. Children receive erythropoietin occasionally; 30% of them are polytransfused, 60% of them suffer from anemia. Four children have never received immunization against hepatitis B and three are seropositive for hepatitis C. None of these children has regular school attendance and psychological support for the child and his family do not exist. We conclude that the situation of children on hemodialysis in Lebanon is alarming. Solutions are possible and available; they need to be undertaken urgently.
Collapse
Affiliation(s)
- C Mourani
- Hôtel-Dieu de France, Unité de dialyse pédiatrique, Beyrouth, Liban.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Mourani C, Mallat S, Moukarzel M, Bassil Z, Akatcherian C. Dilemma of oxalosis in end stage renal failure: isolated kidney allograft or hemodialysis. J Med Liban 1999; 47:317-20. [PMID: 10887538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
We report the case of a 10-year-old girl who received a cadaveric kidney transplant for oxalosis after a period of 12 months on hemodialysis. The donor was a 6-year-old child. Cold ischemia was four hours. Diuresis occurred immediately in the operating room. Mean daily diuresis was maintained at 8 liters: first by i.v. perfusion, then by nocturnal continuous nasogastric hydration. In addition to the usual immunosuppressive drugs, she received pyridoxine, sodium citrate, phosphate, hydrochlorothiazide and magnesium. Daily hemodialysis was performed from Day 1 to Day 9 and four additional sessions every other day. The postoperative course was satisfactory. Oxaluria was elevated initially at 1074 mg/24 h (normal < 50 mg/24 h). One year later, mean daily diuresis is still 8 liters, renal function is normal and oxaluria is at 296 mg/24 h. Repeated graft sonography showed no nephrocalcinosis, but mild oxalate deposits are noted on renal biopsy. Isolated renal transplantation was successful in our patient. It allowed us to stop hemodialysis and to avoid extra-renal accumulation of oxalate. Despite this success, we are convinced that long term prognosis is uncertain and liver transplantation should be realized to correct definitely the biochemical defect.
Collapse
Affiliation(s)
- C Mourani
- Department of Pediatrics, Hôtel-Dieu de France Hospital (HDF), Beirut, Lebanon.
| | | | | | | | | |
Collapse
|
12
|
Abstract
BACKGROUND Hypomagnesemia-hypercalciuria and nephrocalcinosis is a rare inherited syndrome which is characterized by persistent hypomagnesemia despite supplementation, hypercalciuria, nephrocalcinosis and progressive renal failure. OBSERVATIONS Case 1. A girl was referred at the age of 18 months because of polyuria, polydipsia and vitamin-resistant rickets. There was hypomagnesemia, hypercalciuria and mild renal insufficiency; ultrasonography showed nephrocalcinosis. For two years, she received hydrochlorothiazide and the course of the disease was marked by a significant reduction of urine output and hypercalciuria, recurrent urinary tract infections and a progression toward chronic renal failure. Case 2. The brother of this child was investigated at the age of nine months because of polyuria and polydipsia. He also had hypomagnesemia, hypercalciuria and nephrocalcinosis. Renal function was initially normal. After two years on continuous treatment with hydrochlorothiazide, hypercalciuria decreased without deterioration of renal function. No signs of rickets were noted and nephrocalcinosis remained stable. CONCLUSION To our knowledge, these two patients are the youngest reported in the literature. The long-term deterioration of renal function is hazardous but rickets may be avoided by early administration of hydrochlorothiazide.
Collapse
Affiliation(s)
- C Mourani
- Département de pédiatrie, Hôtel-Dieu de France, Liban, France
| | | | | | | | | |
Collapse
|
13
|
Mourani C, Hage G, Akatcherian C. [Familial hemolytic and uremic syndrome]. Arch Pediatr 1999; 6:336-7. [PMID: 10191907 DOI: 10.1016/s0929-693x(99)80278-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
14
|
Mourani C, Moukarzel M, Gerbaka B, Mallat S, Akatcherian C. [Kidney transplantation in the child. Experiences of l'Hôtel-Dieu de France]. J Med Liban 1999; 47:7-12. [PMID: 10570897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
A retrospective study was conducted on all kidney transplantations performed between January 1993 and June 1996 in our multidisciplinary pediatric department. Thirteen children with a mean age of 6 years (3.5-12) were transplanted during the study period after an average waiting time of 2 years on dialysis for cadaveric transplants and 3.5 months for living related ones. No urologic complication was noted; however, intra-abdominal approach was decided to be performed only in children less than 9 kg. This decision was taken after the occurrence of one intestinal intussusception and two ileal obstructions. During these 3.5 years, five rejection episodes were treated: three were steroid responsive, two were resistant but responded respectively to plasmapheresis and to OKT3. The actuarial survival of the grafts and recipients were 100% for an average mean time of follow-up of 18 months. The latest serum creatinine and creatinine clearance averages were respectively 66 mumol/l and 105 ml/min/1.73 m2. In seven transplanted children for more than 18 months growth was satisfactory. Eleven children returned to school. Kidney transplantation is the optimal treatment for children and infants with chronic renal failure; however, this technique needs a highly experienced team and a permanent close follow-up. Some children with end stage renal disease can directly have preemptive transplantation which is becoming our recent choice to avoid the hemodialysis strain.
Collapse
Affiliation(s)
- C Mourani
- Département de Pédiatrie, Hôtel-Dieu de France (HDF), Université Saint-Joseph (USJ), Beyrouth, Liban.
| | | | | | | | | |
Collapse
|
15
|
Mourani C, Hage G, Mallat S, Gerbaka B, Akatcherian C. Renal biopsy in children in a developing country in 61 consecutive cases. J Med Liban 1998; 46:136-9. [PMID: 10095844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Percutaneous renal biopsy in children is a safe procedure. It is used for definitive diagnosis, prognosis and evaluation of the response to therapy. Repeated percutaneous biopsies are currently performed especially in allograft kidneys and in native kidneys as well. No major complications were noted in our series. The use of the new automated technique with small disposable needles in a well sedated child and experienced operator minimizes the complication rate. The important clinical benefit of the percutaneous renal biopsy overcomes the minimal risk of the procedure. Mesangiocapillary glomerulonephritis and focal segmental glomerulosclerosis are the predominant histological findings in our series. More data from other centers are necessary to evaluate the real incidence of the different entities of renal diseases in our country.
Collapse
Affiliation(s)
- C Mourani
- Department of Pediatrics, Hôtel-Dieu de France Hospital (HDF), Beirut, Lebanon
| | | | | | | | | |
Collapse
|
16
|
Mourani C, Haddad-Zebouni S, Gerbaka B, Akatcherian C. -Radiologic case of the month. Arterial hypertension and ureteral notching-. Arch Pediatr 1998; 5:319-20. [PMID: 10328002 DOI: 10.1016/s0929-693x(97)89376-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- C Mourani
- Département de pédiatrie, CHU Hôtel-Dieu-de-France, Beyrouth, Liban
| | | | | | | |
Collapse
|
17
|
Mourani C, Melki I, Haddad-Zebouni S, Akatcherian C. [Adrenal hematoma may mask renal vein thrombosis]. Arch Pediatr 1998; 5:92. [PMID: 10223121 DOI: 10.1016/s0929-693x(97)83476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
18
|
Mourani C, Mallat S, Akatcherian C, Moussalli A. Reversible severe vascular rejection after plasmapheresis. J Med Liban 1998; 46:40-2. [PMID: 9795522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
Vascular rejection in a transplanted child is frequently associated with bad prognosis on the short and long term. All therapeutic modalities available nowadays as monoclonal antibodies, intravenous cyclosporine or plasma exchange have given conflicting results. We report the case of a boy who was transplanted from his mother at the age of three. His primary disease was a cortico-resistant rapidly progressive glomerulonephritis; the immediate postoperative period was satisfactory but he developed a severe vascular rejection on day 5 post-transplantation, while on triple immunosuppression therapy associating antithymocyte globuline, prednisolone and azathioprine. Acute vascular rejection was corticoresistant but responded well to plasma exchange. In our patient, we believe that plasmapheresis was efficaceous on the reversibility of vascular rejection and moreover that he had not responded to corticotherapy even a week post methylprednisolone in the absence of any change in immunosuppression during plasmapheresis. No randomized study was realized until now to prove the efficacy of plasmapheresis in children with vascular rejection. The sporadic cases reported on the reversibility of such rejection after plasmapheresis, the innocuity of this therapy, if well performed in children, encourage us to consider this treatment modality in resistant vascular rejection.
Collapse
Affiliation(s)
- C Mourani
- Department of Pediatrics, Hotel-Dieu de France Hospital, Beirut, Lebanon
| | | | | | | |
Collapse
|
19
|
Haddad-Zebouni S, Hindy R, Rahi S, Slaba S, Aoun N, Abi Ghanem S, Akatcherian C, Atallah N. [Value of sonography in prolonged neonatal jaundice. Findings in 13 cases]. Arch Pediatr 1998; 5:35-40. [PMID: 10223110 DOI: 10.1016/s0929-693x(97)83465-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Different conditions are associated with a prolonged cholestatic jaundice in the neonatal period: viral hepatitis, biliary atresia and choledocal cyst are the most frequent causes. Laboratory findings are necessary, although they do not permit an etiologic diagnosis in all cases. Serial ultrasonographic study could be proposed for the evaluation of biliary excretion before and after feeding, in order to differentiate between these three conditions. PATIENTS AND METHODS Between February 1993 and January 1997, 13 newborns (seven girls and six boys) aged from 30 to 186 days, presented with jaundice and conjugated hyperbilirubinemia. They were evaluated by laboratory tests; serial ultrasonographic examinations were performed after 4 hours fasting then 1 and 2 hours after meal. RESULTS The gallbladder (GB) was visualized in nine patients. In five of these patients, it contracted after feeding suggesting the diagnosis of neonatal hepatitis, that was confirmed by the clinical evolution. In three patients, the GB did not change in size and the diagnosis of biliary atresia was surgically proven. In one patient, a choledocal cyst was visualized and confirmed by surgery. The GB was not identified after 4 hours of fasting in four patients; biliary atresia was suspected and confirmed by surgery. CONCLUSION Serial ultrasound of the GB is an easy and non-invasive method. It was useful in identifying those conditions requiring surgery in eight patients. We recommend its use as the initial method in the evaluation of neonatal jaundice before the other invasive methods.
Collapse
|
20
|
Abstract
We hereby report the second case of antenatally diagnosed "neurenteric cyst" in the literature. The patient we describe presented as a neonatal respiratory distress syndrome (NRDS) which did not respond to a vigorous resuscitation. Anomaly of the antenatal ultrasonography and of the initial chest x-ray added to the non-response to therapy, led us to an urgent thoracic scan and to a lifesaving thoracotomy. We think that every posterior mediastinal cystic mass, with or without vertebral malformations, diagnosed antenatally, should raise the possibility of neurenteric cyst. The perinatal management of the newborn to be, will thus be simplified. This will lead to a better outcome.
Collapse
Affiliation(s)
- P Daher
- St Joseph University, Department of Paediatrics, Hôtel Dieu de France Hospital, Beyrouth, Lebanon
| | | | | | | | | | | |
Collapse
|
21
|
Gerbaka B, Rassi P, Ghosn A, Beaufils F, Akatcherian C. Accidents chez l'enfant (AE). Arch Pediatr 1996. [DOI: 10.1016/0929-693x(96)86273-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
22
|
Gerbaka B, Rassi P, Chaib-Ghosn A, Beaufils F, Akatcherian C. [Accidents in children. Retrospective epidemiological study of 1671 cases collected at the Hotel-Dieu of Beirut]. J Med Liban 1996; 44:209-13. [PMID: 9289497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Injuries are the first cause of death in children after the neonatal age; their prevention is still critical in Lebanon. At Hotel-Dieu de France Hospital, 1671 children aged less than 18 years have had their files reviewed in the emergency department. Minor traumas represent less than half the cases. Though most of the injuries were light, in 5% of cases primary care was necessary, and 11% were admitted (10% in the Pediatric Intensive Care Unit); 0.5% of the children died upon arrival. Moreover, 15% of our Pediatric Intensive Care Unit population are admitted for accidents. Boys are more frequently affected (69%); toddlers, small children and adolescents are risky populations. After minor traumas, the most frequent accidents are: falls (21.3%), traffic road accidents (8.9%), poisoning (5.7%) and burns (5%). Firearms injuries seem rare (2.8%) but are, in this study, the first cause of mortality. Foreign body inhalation are very rare (< 1%) but are a significant source of morbidity. This analysis is compared to published data, and allows accurate and general recommendations for injuries prevention in children.
Collapse
Affiliation(s)
- B Gerbaka
- Université Saint-Joseph, Département de pédiatrie, Centre hospitalier et universitaire Hôtel-Dieu de France, Beyrouth, Liban
| | | | | | | | | |
Collapse
|
23
|
Melki I, Nabbout R, Nasnas R, Akatcherian C. [Right-sided endocarditis caused by Staphylococcus aureus during the neonatal period. (A case report)]. J Med Liban 1993; 41:90-94. [PMID: 8057350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Right-sided infectious endocarditis in the neonate, due to staphylococcus aureus, is a rare entity. A high index of suspicion should be used when dealing with a very sick neonate, especially with aggressive reanimation. Although the diagnosis is clinical, echocardiography is essential to confirm the diagnosis and also is an excellent mean to follow the evolution of the disease. The pathogenesis of the infection is due to bacteremia with implantation of the staphylococcus on a normal endothelium. The prognosis is poor with a high mortality rate and possibility of sequelae (essentially cardiac and neurologic). The prognosis depends essentially on early diagnosis and treatment which should last for at least 4-6 weeks. The authors present the case of a 2-week-old girl who developed a right-sided staphylococcal endocarditis following treatment of neonatal jaundice with i.v. perfusion of albumin. The patient survived with cardiac and central nervous system sequelae.
Collapse
Affiliation(s)
- I Melki
- Université St Joseph, Hôtel-Dieu de France, Service de pédiatrie, Beyrouth
| | | | | | | |
Collapse
|
24
|
Bitar E, Salibra G, Khoury K, Nasr W, Akatcherian C, Majdalani E, Vassoyan J, Aoun JP, Ayoun SS, Tabet M. [Muscular manifestations in periodic disease]. Rev Rhum Mal Osteoartic 1988; 55:261-3. [PMID: 3287589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Between 1976 and 1983, the authors studied 50 new patients affected with periodic disease. 16 of them-mean age: 29-presented muscular manifestations. They may be grouped into two clinical aspects: muscular pain and contractures. The authors consider that these symptoms, first described in 1945, are an inherent part of the clinical picture of the disease. They discuss their relationship with periarteritis nodosa and remind the fact that their pathogenesis remains unknown.
Collapse
Affiliation(s)
- E Bitar
- Service de Gastro-entérologie, Hôtel-Dieu de France, Beyrouth
| | | | | | | | | | | | | | | | | | | |
Collapse
|