J.-B. Armengaud

Pertussis in young infants: apnoea and intra-familial infection

This study investigated 41 infants, aged <4 months, who were hospitalised with symptoms compatible with pertussis. Of these, 16 had Bordetella pertussis infection confirmed by real-time PCR. For four of these 16 patients, the initial sample was PCR-negative, but samples collected 5-7 days after the onset of infection were PCR-positive. PCR was also positive with samples from 15/16 families and 20/41 household contacts. Nine of the 20 positive household contacts were asymptomatic. Among the 16 infants with proven pertussis, apnoea was more frequent than in a control group for whom PCR was negative with both children and household contacts (69% vs. 28%). It was concluded that real-time PCR performed with samples from household contacts facilitates the diagnosis of infants suspected clinically of having pertussis, thereby enabling earlier treatment.

Case 2: Paediatric chronic osteomyelitis : report of two cases

CASE A previously healthy 14-year-old boy with 1-day history of chest pain, a few hours of 38.5◦C fever and pneumomediastinum on chest X-ray was admitted to the paediatric intensive care unit. History was unremarkable except for immigration to Israel from Uzbekistan 5 years prior to the present illness and 3-years history of smoking. On admission he appeared pale; his temperature was 37◦C, pulse rate 117/min, respiratory rate 26/min, blood pressure 139/76 and O2 Saturation 98% in room air. The rest of the physical examination was unremarkable. Complete blood count revealed WBC of 15.3 × 103/ L, haemoglobin of 14.7 g/dL and CRP of 66 mg/L. The rest of

Kawasaki disease in France, Kawanet: incomplete forms are frequent and associated with a high frequency of cardiac complications

KD is the main vasculitis affecting children before 5 years and the leading cause of acquired heart disease. The epidemiologic of KD is few reported in France within a population from different ethnic backgrounds. Even IVIG is still the standard treatment; the management of patients at risk for cardiac complications may change toward reinforced (and new) therapeutic approaches.

Traitement des plaies « simples » : choix des différentes sutures

The suture, when possible, is the best method to close a simple wound. It must be preceded by debridement and performed with great care. A rigorous technique applied in the best possible environment is necessary but not always sufficient to achieve a good cosmetic result.