RESUMO
Discovery of an enlarged spleen in a child requires steps to identify the etiology. One hundred and seventy-eight patients seen over a four-year period (1985-1988) at the Cocody Teaching Hospital were reviewed. The incidence of splenic enlargement among pediatric inpatients was 1.6%. Males (n = 106) were more often affected than females (n = 72). Slightly over half the children (54.49%) were 0 to 5 years of age. The main clinical presenting features were fever (90%), anemia (72%), a decline in general health (36.50%), enlargement of the liver (33.50%), jaundice (26.50%), and enlarged lymph nodes (7%). Type II of Hackett's classification accounted for most cases (61.80%), followed by Type III (14%). Main etiologies included malaria (53%), salmonella infections (15%), sickle cell anemia (14%), schistosomiasis (9%), AIDS (3%), and thalassemia (2%). Malignancies (leukemia, lymphoma) were relatively infrequent. More than one etiology was found in 13 cases. The distribution of etiologies by age group was determined and a strategy for investigating children with splenic enlargement in tropical countries was developed.
Assuntos
Esplenomegalia/etiologia , Adolescente , Fatores Etários , Criança , Pré-Escolar , Côte d'Ivoire/epidemiologia , Árvores de Decisões , Feminino , Hospitais Universitários , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Fatores Sexuais , Esplenomegalia/classificação , Esplenomegalia/epidemiologiaRESUMO
In a study involving 104 children hospitalized with diarrhoea, 9% were infected with oocyst Cryptosporidium spp. add 56% with such yeast-fungus as Candida (C. Candida 38%). The manifestations noted in cryptosporidiosis infected children are acute diarrhea, vomiting and hyperthermia. One subject out of five who were tested for antibody to HIV appeared to be antibody positive. The patients immunity from the disease was not checked. A mycological test must be systematically carried out in case of children diarrheal outbreak.
Assuntos
Candida/isolamento & purificação , Coccídios/isolamento & purificação , Cryptosporidium/isolamento & purificação , Diarreia Infantil , Animais , Pré-Escolar , Côte d'Ivoire , Diarreia Infantil/microbiologia , Diarreia Infantil/parasitologia , Feminino , Anticorpos Anti-HIV/análise , HIV-1/imunologia , HIV-2/imunologia , Humanos , Lactente , MasculinoRESUMO
A retrospective study of 107 neonates with meningitis showed that in 45% of cases the condition occurred during the first 48 hours after birth, probably following a materno-foetal infection. Male neonates accounted for 70% of the cases. In 15% of cases, the mothers previously had a known infectious disease and 55% of cases came from an unfavourable socio-economic environment. Over 50% of the infants had to be resuscitated at birth. The majority of organisms isolated were Gram-negative bacteria or Enterobacteriaceae; the commonest organism was Haemophilus influenzae. The most effective specific treatment (91% favourable results) was intravenous amoxycillin plus intramuscular gentamicin. It is recommended that the newborn infant of parents living in unfavourable socio-economic circumstances should receive careful follow-up during the first week after birth so that the diagnosis of bacterial meningitis can be made at the start of infection. The neonate should receive effective prophylactic antibiotic cover if resuscitated, if the mother has suffered from an infectious disease during pregnancy or if premature rupture of the membranes has occurred.