RESUMO
We report the case of a 13-year-old child admitted to the ICU because of Atractylis gummifera poisoning. This plant is poisonous, with a liver tropism and is a public health problem in the pediatric population. Beyond this observation, we review this intoxication, whose diagnosis is clinical, treatment is symptomatic and prevention is crucial.
Assuntos
Atractylis/intoxicação , Intoxicação por Plantas/mortalidade , Adolescente , Bloqueio de Ramo/induzido quimicamente , Bloqueio de Ramo/diagnóstico , Bloqueio de Ramo/mortalidade , Bloqueio de Ramo/terapia , Doença Hepática Induzida por Substâncias e Drogas/diagnóstico , Doença Hepática Induzida por Substâncias e Drogas/mortalidade , Doença Hepática Induzida por Substâncias e Drogas/terapia , Evolução Fatal , Escala de Coma de Glasgow , Hospitais Universitários , Humanos , Unidades de Terapia Intensiva , Masculino , Marrocos , Admissão do Paciente , Intoxicação por Plantas/diagnóstico , Intoxicação por Plantas/terapiaRESUMO
INTRODUCTION: The available microbiological data on community-acquired peritonitis in children are inadequate, and antibiotic therapy is not consensual. Our work aims to study the bacteriology of peritonitis in children in our region and discuss the appropriate antibiotherapy. PATIENTS AND METHODS: A descriptive study spread over one year. We collected cases of peritonitis in which a microbiological study of peritoneal fluid was performed. RESULTS: Of 38 cases, the most frequently isolated bacteria is Escherichia coli (E. coli) (50%). Its sensitivity was 64% to amoxicillin-clavulanate, 93.33% to third generation cephalosporins (C3G) and 100% to ertapenem and aminozides. CONCLUSION: We find a high rate of resistance of E. coli to amoxicillin-clavulanic acid. This prompts us to reconsider our therapeutic approach. We believe that the association C3G+aminoglycoside+metronidazole should be used first-line in the pediatric peritonitis in our context.
Assuntos
Infecções Comunitárias Adquiridas/microbiologia , Peritonite/microbiologia , Adolescente , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Líquido Ascítico/microbiologia , Cefalosporinas/uso terapêutico , Criança , Pré-Escolar , Infecções Comunitárias Adquiridas/tratamento farmacológico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Feminino , Hospitais Universitários , Humanos , Lactente , Masculino , Metronidazol/uso terapêutico , Testes de Sensibilidade Microbiana , Marrocos/epidemiologia , Peritonite/tratamento farmacológico , Peritonite/epidemiologiaRESUMO
Acute pancreatitis in children is rare and is characterized by clinical, biological, and etiological polymorphism. We report the case of a 6-year-old child who underwent surgery for intestinal obstruction. The diagnosis of acute pancreatitis was made after the surgical exploration. Initial laboratory tests showed hyperlipasemia and mild hypertriglyceridemia. After 2 weeks of hospitalization, we found severe hypertriglyceridemia, which was considered the cause of acute pancreatitis. Based on a review of the literature, we emphasize the importance of considering acute pancreatitis in the diagnosis of abdominal pain in children. Hypertriglyceridemia is one of its rare causes and must be detected because specific treatments are needed. Blood triglyceride concentration in the initial phase can be misleading and the assay should be repeated after the acute episode.
Assuntos
Hipertrigliceridemia/complicações , Hipertrigliceridemia/diagnóstico , Pancreatite Necrosante Aguda/diagnóstico , Pancreatite Necrosante Aguda/etiologia , Dor Abdominal/etiologia , Criança , Diagnóstico Diferencial , Humanos , Obstrução Intestinal/cirurgia , Lipase/sangue , Masculino , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Tomografia Computadorizada por Raios X , Triglicerídeos/sangueRESUMO
INTRODUCTION: Deep penetrating traumas of the axilla extending to the neck are rare and potentially dangerous. OBSERVATION: An 11-year-old child presented with an impressive penetrating axillary injury extending to the neck after falling on a tree branch. The wound was explored in the operating room (OR). A fragment of the branch was removed without injuring any vascular structure. The only lesion concerned the hypopharynx. DISCUSSION: Cervical wounds may have an axillary origin. These wounds must be systematically explored in the OR, given the risk of upper airway obstruction and vascular lesion.