Neonatal bacterial meningitis represents a major cause of mortality and morbidity in newborns worldwide. It leads to immediate and long-term neurological complications. We report a case of a term newborn with an unremarkable pregnancy and delivery, who was admitted to our neonatal ward on the fifth day of life for fever. Cerebrospinal fluid culture was positive for Escherichia coli. The infant had neurological deterioration and continued fever despite adequate antibiotic therapy. Brain MRI showed multiple subdural abscesses with ventriculitis. Antibiotic therapy was maintained for 90 days with total resolution of the abscesses. The child has a normal physical examination and appropriate psychomotor development at 9 months of age.

Acute intoxication with nicotine is possible to cause nonspecific clinical signs and may be serious and lead to the death. We report a rare and severe form of acute nicotine poisoning secondary to dermal absorption of tobacco.

Introduction Takayasu arteritis is an idiopathic chronic granulomatous panarteritis predominantly affecting the aorta and its main branches. The diagnosis is based on a set of clinical, biological and radiological criteria. Observation Thes are two girls, averag age 12 years. They presented a decrease in visual acuity and high blood pressure. One of the two girls had right radial and brachial pulse abolished. In the two cases a bilateral edema was objectified. An hypokalemia was noted in one case. The angio scanner showed a stenosis of the right subclavian artery with stenosis of the aortic arch extended to both renal arteries, with complete occlusion of the right right renel artery. For the other child, the aortic angiocan showed non-stenosing focal thikening of the descendeng aorta, with pre stenosis occlusive from the origin of the right renel artery. There was no brain damage in the two cases. One of the two girls was treated with a high-dose corticosteroid with methotrexate and an antihypertensive drug. The other child was treated with potassium supplementation in addition to antihypertensive treatment. Conclusion Takayasu arteritis is a chronic vasculitis of unknown etiology. Rare in children, it is a worldwide disease with significant morbidity and mortality.

La glomérulonéphrite aiguë (GNA) post-streptococcique est une cause fréquente de glomérulonéphrite aiguë chez l'enfant. L'objectif de ce travail était de décrire les particularités cliniques et évolutives et de chercher des facteurs prédictifs de sévérité. Il s'agissait d'une étude rétrospective descriptive des patients atteints de GNA hospitalisés dans le service de pédiatrie, urgences et réanimation pédiatrique du CHU Hédi Chaker de Sfax sur une période de 12 ans (2005–2016). Ont été inclus 178 patients. L'âge moyen des patients était de 7,6 ans ± 3,43 ans. Cent quarante deux patients (80 %) avaient des antécédents d'infection récente des voies respiratoires supérieures ou d'infection cutanée. L'angine représentait la cause la plus fréquente, retrouvée chez 113 malades (67,6 %). À l'examen initial, 135 enfants (75,8 %) avaient une hématurie macroscopique. Les oedèmes étaient présents chez 114 enfants (64 %). L'HTA était notée chez 55 patients (31 %). L'oligurie était notée chez 30 enfants (16,8 %). Soixante-six patients (37 %) ont développé une insuffisance rénale aiguë (créatinine sanguine ≥ 70 micromoles/L). Il n'y avait pas de corrélation entre la survenue d'une insuffisance rénale aiguë et l'âge, le sexe, l'infection déclenchante, l'anémie, ni avec l'hyperleucocytose. Une créatininémie supérieure à 56,35 micromoles/L était associée à un haut risque d'apparition d'une hypertension artérielle. La durée moyenne d'hospitalisation était de 5,8 jours ± 4,44. Un seul malade a évolué vers une insuffisance rénale chronique. La GNA post-streptococcique demeure une néphropathie fréquente dans notre région. La détection et le traitement efficace de toute infection susceptible d'être en cause permettraient de réduire l'incidence de cette pathologie. Post-streptococcal glomerulonephritis (PSGN) is a frequent cause of acute nephritis in children. This study aimed to describe the epidemiology, clinical characteristics and outcomes of PSGN and look for predictor's factors of severity. A 12-year retrospective review of case notes and laboratory data was conducted at a department of pediatrics, pediatric emergency and intensive care, Hedi Chaker Hospital. One hundred seventy eight children were treated for PSGN with a mean age of 7.6 ans ± 3.43 ans. One hundred and forty-two patients (80%) had a history of a recent upper respiratory tract or skin infection. Streptococcal pharyngitis was the most common cause, identified in 113 patients (67.6%). Macroscopic hematuria and edema were noted in 135 (75.8%) and 114 cases (64%) respectively. Hypertension was present in 55 patients (31%). Oliguria was noted in 30 children (16.8%). Sixty-six subjects (37%) developed acute renal impairment (creatinine ≥ 70 micromoles/L). No correlation was demonstrated between acute renal impairment and age, sex, triggering infection, anemia and white blood cell count. Creatinine greater than 56.35 micromoles/L was associated with a high risk of developing high blood pressure. The mean length of admission was 5.8 days ± 4.44. Only one subject has ongoing renal dysfunction. PSGN remains a common nephropathy in our region. The detection and effective treatment of any infection that may be involved can reduce the incidence of this disease.

Aim. - Post-streptococcal glomerulonephritis (PSGN) is a frequent cause of acute nephritis in children. This study aimed to describe the epidemiology, clinical characteristics and outcomes of PSGN and look for predictor's factors of severity. Methods. - A 12-year retrospective review of case notes and laboratory data was conducted at a department of pediatrics, pediatric emergency and intensive care, Hedi Chaker Hospital. Results. - One hundred seventy eight children were treated for PSGN with a mean age of 7.6 ans +/- 3.43 ans. One hundred and forty-two patients (80%) had a history of a recent upper respiratory tract or skin infection. Streptococcal pharyngitis was the most common cause, identified in 113 patients (67.6%). Macroscopic hematuria and edema were noted in 135 (75.8%) and 114 cases (64%) respectively. Hypertension was present in 55 patients (31%). Oliguria was noted in 30 children (16.8%). Sixty-six subjects (37%) developed acute renal impairment (creatinine >= 70 micromoles/L). No correlation was demonstrated between acute renal impairment and age, sex, triggering infection, anemia and white blood cell count. Creatinine greater than 56.35 micromoles/L was associated with a high risk of developing high blood pressure. The mean length of admission was 5.8 days +/- 4.44. Only one subject has ongoing renal dysfunction. Conclusion. - PSGN remains a common nephropathy in our region. The detection and effective treatment of any infection that may be involved can reduce the incidence of this disease. (C) 2018 Societe francophone de nephrologie, dialyse et transplantation. Published by Elsevier Masson SAS. All rights reserved.

Introduction: Pediatric urolithiasis remains endemic in low-resource countries affecting children <1 to 15 years. This study aimed to investigate the diagnosis and the treatment options of pediatric urolithiasis and compare that with the literature. Materials and methods: This study retrospectively evaluated patients who had been diagnosed with urolithiasis in the in department of pediatric emergency and reanimation and the department of pediatric surgery in Hedi Chaker hospital in Sfax between 2001 and 2016. Results: Over 16 years period, we diagnosed and managed 78 children with urolithiasis. 44 were male (56%) and 34 were female (44%). The median age was 54 months (4 to 144 months). Family history of urolithiasis was found in 23 patients (29.5%). The diagnosis of urolithiasis was made after Urinary tract infection in 23 (29.5%), abdominal pain in 16 (20.5%), Hematuria in 9 (11.5%), nephritic colic in 8 (10.5%), dysuria in 11(14%) and after antenatal diagnosis of malformative uropathies in 11 (14%) patients. The treatment were surgery in 32, medical in 30, LEC and endoscopy in 8 patients. The mean of follow up was 36 months and we had 11 recurrent urolithiasis. Conclusion: Pediatric urolithiasis remains a devastating health problem. Their management requires more exploration especially in the etiology research for a best management.

Background: Peutz-Jeghers syndrome is a rare, autosomal dominant inherited disease caused by mutation of STK11/ LKB1 (serine threonine kinase 11) characterized by gastrointestinal hamartomatous polyps, mucocutaneous pigmentation and increased risk of malignant disease. The case of a 12-year-old girl with perioral pigmentation who present with recurrent vomiting and weight loss is reported. Endoscopic and radiologic investigation demonstrated a mass in the second portion of the duodenum. She underwent surgery because of a sharp abdominal pain caused by bowel intussusception. Laparotomy revealed two polyps: one in the second portion of the duodenum: Intussusception could be easily reduced and polyps are resected. Histologically, it was a hamartoma. The child was found to be heterozygote for the mutation c.863-2A>C in intron 6 of the STK11 gene. The patient is followed and is well. Conclusion: Peutz-Jeghers syndrome should be suspected in any child suffering from recurrent abdominal pain and /or other gastrointestinal symptoms in the presence of characteristic pigmentation.