Mesenteric Defect with Internal Herniation: A Rare Cause of Bowel Obstruction in Newborn.

Herniation through a congenital mesenteric defect is a rare cause of intestinal obstruction in the newborn. Early diagnosis and surgical treatment improves the prognosis. We present a case of a full-term infant who presented with respiratory distress at birth.

Predictors of Mortality in Mechanically Ventilated Critical Pertussis in a low Income Country.

Background: Critical pertussis is characterized by severe respiratory failure, important leukocytosis, pulmonary hypertension, septic shock and encephalopathy.

Aim: To describe the clinical course of critical pertussis, and identify predictors of death at the time of presentation for medical care.

Methodology: Retrospective study conducted in children's hospital Tunisian PICU between 01 January and 31 October 2013.

Findings of the International Nosocomial Infection Control Consortium (INICC), part III: effectiveness of a multidimensional infection control approach to reduce central line-associated bloodstream infections in the neonatal intensive care units of 4 developing countries.

Objective: To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach to reduce central line-associated bloodstream infection (CLABSI) rates.

Setting: Four neonatal intensive care units (NICUs) of INICC member hospitals from El Salvador, Mexico, Philippines, and Tunisia.

Patients: A total of 2,241 patients hospitalized in 4 NICUs for 40,045 bed-days.

Socioeconomic impact on device-associated infections in pediatric intensive care units of 16 limited-resource countries: international Nosocomial Infection Control Consortium findings.

Objectives: We report the results of the International Nosocomial Infection Control Consortium prospective surveillance study from January 2004 to December 2009 in 33 pediatric intensive care units of 16 countries and the impact of being in a private vs. public hospital and the income country level on device-associated health care-associated infection rates. Additionally, we aim to compare these findings with the results of the Centers for Disease Control and Prevention National Healthcare Safety Network annual report to show the differences between developed and developing countries regarding device-associated health care-associated infection rates.

Neurological variant of Lemierre's Syndrome with purulent meningitis: a case report and literature review.

We report an unusual variant of Lemierre's Syndrome (LS) in a 10-year-old-girl admitted to the intensive care unit for septic shock with meningitis. The primary infection was otitis media. A gram negative bacillus was identified in the direct exam of the purulent ear discharge and the cerebrospinal fluid but cultures were negative.

Community-acquired methicillin-resistant Staphylococcus aureus infections requiring admission to a Tunisian pediatric intensive care unit.

Background: There is limited literature describing severe community acquired methicillin-resistant S aureus (CA-MRSA) in children admitted to an intensive care unit.

Aim: To review clinical features and outcome of children admitted in a Tunisian pediatric intensive care with CA-MRSA.

Methods: Retrospective chart review of patients coded for CAMRSA over 10 years.

Lidocaine toxicity secondary to local anesthesia administered in the community for elective circumcision.

We report three previously healthy infants aged, respectively, 23 days, 6 weeks, and 3 months with systemic lidocaine toxicity following administration of subcutaneous lidocaine for regional anesthesia during an elective circumcision. The patients developed a generalized seizure requiring endotracheal intubation but recovered fully with supportive care. We report the clinical details of these cases as well as a review of lidocaine toxicity.

Community-associated methicillin-resistant Staphylococcus aureus infections in a pediatric intensive care unit.

Introduction: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is an increasing problem worldwide. In developing countries, there is little data on CA-MRSA infection in children. This study reviewed the clinical features and outcomes of children admitted in a Tunisian pediatric intensive care unit with severe CA-MRSA infections.

Management of meconium aspiration syndrome with highfrequency oscillatory ventilation.

Background: High-frequency oscillatory ventilation (HFOV) has been advocated for use to improve lung inflation while potentially decreasing lung injury. There were few data on the early use of HFOV in hypoxemic term neonates.

Aim: To evaluate the effectiveness of HFOV, used as the initial mode of ventilation, in neonates with severe meconium aspiration syndrome (MAS).

Fatal subdural empyema caused by Streptococcus constellatus and Actinomyces viscosus in a child--case report.

Group milleri streptococci that colonize the mouth and the upper airways are generally considered to be commensal. In combination with anaerobics, they are rarely responsible for brain abscesses in patients with certain predisposing factors. Mortality in such cases is high and complications are frequent.

Community acquired methicillin-resistant Staphylococcus aureus preseptal cellulitis complicated by zygomatic osteomylitis, cavernous sinus thrombosis and meningitis in a healthy child.

We report a case of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA) preseptal cellulitis complicated by zygomatic osteomyelitis, cavernous sinus thrombosis, meningitis, and necroziting pneumonia in a previously healthy two and half month old girl. This case exemplifies an aggressive and disseminated CA-MRSA infection with deep venous thrombosis in an infant without predisposing risk factors. The literature is reviewed and recommendations for management are provided.

[Early neonatal infection caused by Streptococcus pneumonias: report of 3 cases].

Background: S pneumoniae is a rare cause (1-8 %) of maternofetal infection causing an important morbi-mortality in the newborn and the mother.

Aim: To report 3 cases of early neonatal infection due to S pneumonia.

Cases Report: Three cases of early neonatal infection due to S pneumoniae are reported.

Toxic epidermal necrolysis complicated by small bowel intussusception: a case report.

Intestinal involvement in toxic epidermal necrolysis (TEN) has been identified only rarely. We report a case of TEN complicated by small bowel intussusception. The patient was a previously healthy 8-year-old boy who presented with TEN and extensive lesions, including up to 40% of the body surface area as well as conjunctival, oropharyngeal, respiratory, and genital mucosa.

Multifocal atrial tachycardia: an unusual cause of cardiogenic shock in a newborn.

Background: Chaotic or multifocal atrial tachycardia (MAT) is a rare tachyarrhythmia in children, accounting for less than 1% of supraventricular tachycardia seen in childhood. The majority of children with MAT are healthy; a few may exhibit mild to life threatening cardiorespiratory disease.

Aim: To report a new case of MAT revealed by a severe respiratory distress and cardiogenic shock.

Prevalence of Mycoplasma pneumoniae-associated respiratory tract infections in hospitalized children: results of a 4-year prospective study in Tunis.

Specific microbiologic, molecular, and serologic assays are hardly available in Tunis to confirm a suspected infection of Mycoplasma pneumoniae (MP). These diagnosis methods were used for the first time in a Tunisian prospective study to estimate the prevalence of MP infection in children and to evaluate their usefulness for diagnosis. A total of 540 children hospitalized in Tunis for lower respiratory tract infections (LRTIs) between 2005 and 2009 and 580 clinical specimens were investigated for the presence of MP by culture and by end-point polymerase chain reaction (PCR) targeting the P1 and the 16S rRNA genes.

[Acute disseminated encephalomyelitis associated with Mycoplasma pneumoniae infection in children: 2 case reports].

Background: Extrapulmonary complications of Mycoplasma pneumoniae infection are rare and dominated by nervous system disorders. Two patients suffering from acute disseminated encephalomyelitis associated with M. Pneumoniae infection are reported.

Unusual cause of severe toxic methemoglobinemia in an infant: a case report.

Toxic methemoglobinemia is an uncommon blood disorder induced by exposure to certain oxidizing agents and drugs. In severe cases, this condition may rapidly lead to major cardiopulmonary compromise and constitutes an emergency requiring prompt recognition and early management. We report an unusual case of severe toxic methemoglobinemia following wide cutaneous application of a pomade containing benzocaine, resorcin, and oxyquinoline (Nestosyl) in an infant.

Acute respiratory failure revealing a multilocular thymic cyst in an infant: a case report.

Introduction: Multilocular thymic cysts are rare benign lesions of the neck and mediastinum that can occur at any age. In children, multilocular thymic cysts are usually symptomatic after the age of 2 years and produce few symptoms. We present an unusual case of a multilocular thymic cyst diagnosed in a 3-month-old girl and causing severe respiratory failure.

[Acute respiratory distress syndrome in infants at term and near term about 23 cases].

Aim: to precise the incidence of acute respiratory distress syndrome in infants at term and near term and the clinical characteristics of this disease not yet well recognised.

Methods: Retrospective study of the medical records of infants admitted in the paediatric intensive care unit for ARDS along a period of 4 years. Diagnosis of ARDS was based on the following criterias: (1) Gestational age > or =35 weeks of gestation; (2) Severe and immediate respiratory distress requiring mechanical ventilation with PEEP > or =4 cmH2O and FiO2 > or = 0.

Epidemiology of hospital-acquired bloodstream infections in a Tunisian pediatric intensive care unit: a 2-year prospective study.

Background: There are few data providing rates of nosocomial bloodstream infections (NBI) in pediatric intensive care patients from developing regions of the world.

Objectives: To describe the epidemiology of NBI in a Tunisian pediatric intensive care unit (PICU).

Methods: A prospective surveillance study from January 2004 through December 2005 was performed in the PICU of the Children's Hospital of Tunis.

[Management of purpura fulminans apropos of 21 cases: diagnostic delay and therapeutic problems].

Aim: To evaluate the diagnostic delay and therapeutic insufficiencies delay before the transfer in ICU of the children admitted in the ICU of the children's hospital of Tunis with a purpura fulminans (PF).

Methods: A retrospective, descriptive study, of children with PF referred between January 2000 and January 2006 to a the paediatric intensive care unit (PICU) of the children's hospital of Tunis. The PF diagnosis was retained in any child presenting a feverish purpura and circulatory insufficiency signs.

High-frequency oscillatory ventilation in term and near-term infants with acute respiratory failure: early rescue use.

This study describes a high-frequency oscillatory ventilation (HFOV) protocol for term and near-term infants with acute respiratory failure (ARF) and reports results of its prospective application. Neonates, with gestational age >or= 34 weeks, were managed with HFOV, if required, on conventional ventilation (CV), a fraction of inspired oxygen (F IO(2)) 0.5, and a mean airway pressure > 10 cm H (2)O to maintain adequate oxygenation or a peak inspiratory pressure > 24 cm H (2)O to maintain tidal volume between 5 and 7 mL/kg of body weight.