[Primitive lung abscess: an unusual situation in children]. / Abcès pulmonaire primitif à staphylocoque: situation rare chez l'enfant.

INTRODUCTION: Lung abscess is a localized area of non tuberculosis suppurative necrosis of the parenchyma lung, resulting in formation of a cavity containing purulent material. This pathology is uncommon in childhood. CASE REPORT: A 3-year-6 month-old boy was admitted with prolonged fever and dyspnea. Chest X-ray showed a non systemized, well limited, thick walled, hydric, and excavated opacity containing an air-fluid level. Chest ultrasound examination showed a collection of 6. 8 cm of diameter in the right pulmonary field with an air-fluid level. Hemoculture showed Staphylococcus aureus. The patient received large spectrum antibiotherapy. Three days after, he presented a septic shock and surgical drainage was indicated. Histological examination confirmed the diagnosis of lung abscess. Any underlying condition such as inoculation site, local cause or immune deficiency, was noted and diagnosis of primary abscess was made. The patient demonstrated complete recovery. He is asymptomatic with normal chest X-ray and pulmonary function after 3 years of evolution. CONCLUSION: Lung abscess represent a rare cause of prolonged fever in childhood. An underlying condition must be excluded to eliminate secondary abscess.

[Intervention on smoking in adolescents in Sousse, Tunisia]. / Etude d'intervention sur le tabagisme chez les adolescents dans la région de Sousse, Tunisie.

PURPOSE: To increase knowledge about smoking via a school prevention programme. PATIENTS AND METHODS: This quasi-experimental study included two groups: a control and an intervention group with a pre- and a post-evaluation of knowledge about smoking in each group. The target population consisted of students of 12 to 16 years old in Sousse, Tunisia. To evaluate the intervention, stratified and proportional sampling was used to include 2100 students in the questionnaire. All the students in the intervention group received a standardized program of information about smoking. A pre-tested and self-managed questionnaire in Arabic was used to assess knowledge about smoking, attitudes and behavioural intent before and after the intervention. RESULTS: The intervention group's post-test knowledge and behavioural intent were significantly higher than that of the control group's. No significant differences were found in post-test attitudes between the control and the intervention groups. CONCLUSION: The authors carried out this survey to evaluate the difficulties and resources in order to institute a more complete and durable program.

Diabetic acido-ketosis revealing thiamine-responsive megaloblastic anemia.

Thiamine-responsive megaloblastic anemia (TRMA) is a rare autosomal recessive disorder characterized by megaloblastic anemia, diabetes mellitus and progressive sensorineural deafness. We report the cases of two infants, aged 4 and 5 months, hospitalized for diabetic ketoacidosis requiring insulin therapy. Laboratory tests revealed megaloblasic anemia, thrombocytopenia and normal thiamine level. Neurosensorial investigations showed bilateral deafness and ophthalmic involvement. Treatment with oral thiamine normalized hematological disorders and controlled diabetes; however, thiamine therapy had no impact on neurosensorial disorders.

Foetus-in-fetu: an unusual cause of abdominal mass in the newborn.

Foetus-in-fetu (FIF) is a rare congenital condition in which a vertebrate foetus is incorporated within its twin. The authors report the case of a newborn girl with prenatal ultrasonographic diagnosis of an intra-abdominal mass. Abdominal ultrasonography and computed tomography of the abdomen showed a heterogeneous cystic mass containing multiple calcifications. The patient had a laparotomy at 18 days of age with excision of a well-encapsulated 6 x 5 cm retroperitoneal mass, containing many organs. Anatomicopathologic examination showed a relatively well-differentiated FIF attached to an amniotic sac by a rudimentary umbilical cord. Encephalon, coroidal plexus, vertebral bodies, rudimentary limbs, thyroid gland and teeth were identified. The postoperative period was uneventful.