[Salmonella meningitis in children in Libreville. Retrospective study of 9 cases]. / M eningites à salmonelles de l'enfant à Libreville. Etude rétrospective de neuf observations.

BACKGROUND: Salmonella meningitis is a rare entity, even in tropical area where salmonellosis is common. Its prognosis is poor and the choice of adequate antibiotic therapy is difficult. PATIENTS AND METHODS: The files of nine children (three boys, six girls) admitted to the pediatric unit of the Owendo Pediatric Hospital in Libreville for salmonella meningitis between January 1, 1989, and December 31, 1993 were retrospectively studied. Diagnosis was established by a positive culture of cerebrospinal fluid. RESULTS: Salmonella was the third cause (8.65%) of purulent meningitis observed during this period. Eight children were less than 1-year old, seven were from low socioeconomic standard families. The main clinical manifestations were fever (seven cases), pallor (six cases), diarrhea (four cases), nuchal rigidity (four cases), convulsions (three cases) and bulging fontanel (three cases). Five children (55.5%) were severely anemic (hemoglobin < 5 g/dL) but none had abnormal hemoglobin. Serotyping could not be performed in any case. Salmonella isolates were resistant to chloramphenicol in six cases and to ampicillin in five. Cefotaxime (200 mg/kg/24 h intravenously in three divided doses) was given to seven patients. The duration of therapy was at least 3 weeks in four patients. There were five deaths at ages ranging from 1 to 12 months, ie, a case fatality rate of 55.5%. Three patients (33.3%) recovered with neurological sequels. CONCLUSION: The prognosis of salmonella meningitis is poor, even in the case of prompt diagnosis and adequate therapy. Preventive measures only can decrease the risk of illness in children.

[Bladder stones in children in Gabon. Three case reports]. / La lithiase vésicale chez l'enfant au Gabon. A propos de 3 observations.

Bladder stones are uncommon in children in Gabon. The authors report the case of 3 boys admitted to the Paediatric Hospital of Owendo for voiding disorders. All patients came from the South of the country, but these stones cannot be described as endemic in view of the small number of cases. The authors recall the main aetiologies, the suggestive symptoms and the simple and inexpensive complementary investigations (plain abdominal x-ray and ultrasonography) allowing the definitive diagnosis. Conventional surgical treatment gives good results, but in the case of small stones, endourological treatment can be more economical in terms of the duration of hospital stay and postoperative morbidity.

[Imaging in pediatrics. Strategy and economic implications for the Third World]. / Imagerie en pédiatrie. Stratégie et implications économiques pour le tiers-monde.

The cost of acquiring medical imaging equipment is too high for many Third World nations. Ultrasonography and conventional roentegenography provide adequate data in most pediatric patients in tropical countries, for a low maintenance cost. Special training of practitioners in the use of these investigations is essential, before even performing the necessary choices among available equipment.