Agreement of cardiac index measurements between ultrasonic cardiac output monitor and transthoracic echocardiography in neonates.

Objectives: To evaluate the agreement of cardiac index (CI) calculated by Ultrasonic sonic cardiac output monitor (USCOM) and transthoracic thoracic echocardiography (TTE) in order to know if we can recommend USCOM in our pediatric intensive care unit (PICU).

Design: Prospective observational evaluative study carried out over a period of 3 months Setting: PICU at children's hospital in Tunis Participants: All newborns without tracheostomy or a known congenital heart disease, admitted to the PICU during the study period were enrolled.

Interventions: Paired and consecutive measurements of CI were obtained in all patients with both technologies.

Homozygous TNNI3 frameshift variant in a consanguineous family with lethal infantile dilated cardiomyopathy.

Background: Dilated cardiomyopathy (DCM) is characterized by dilatation of the left ventricle, systolic dysfunction, and normal or reduced thickness of the left ventricular wall. It is a leading cause of heart failure and cardiac death at a young age. Cases with neonatal onset DCM were correlated with severe clinical presentation and poor prognosis.

Retrospective Analysis of Clinical Characteristics and Disease Outcomes in Children and Adolescents Hospitalized Due to COVID-19 Infection in Tunisia.

Due to low susceptibility of coronavirus disease of 2019 (COVID-19) in children, limited studies are available regarding COVID-19 in the pediatric population in Tunisia. The current study evaluated the incidence, clinical characteristics, and outcomes of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection among children hospitalized at Béchir Hamza Children's Hospital. A retrospective cohort analysis was conducted using the hospital database between March 2020 and February 2022 with children aged ≤15 years with SARS-CoV-2 infection (confirmed by RT-PCR).

Critically ill infants with SARS-COV-2 delta variant infection.

Background: SARS-CoV-2 is described to cause mild to moderate symptoms in children. To date, clinical data and symptoms of the Delta variant in pediatric patients are lacking.

Aim: To describe clinical characteristics and outcomes of infants admitted in the pediatric intensive care unit (PICU) during the period of Delta variant predominance.

Severe and critical SARS-COV-2 delta variant infection in infants without underlying medical conditions.

We report herein a case series of infants, with no comorbidities, who developed a life-threatening illness due to the SARS-CoV-2 Delta variant. We retrospectively reviewed the medical records of children, aged under 15 years, admitted to PICU, during the peak of Delta infection, between June 23 and August 16 2021, with severe and critical forms of SARS-CoV-2 infection, confirmed by RT-PCR. Twenty infants were included, the median age was 47 days (IQR: 26.

Phylogeography and phylogeny of Rhinoviruses collected from Severe Acute Respiratory Infection (SARI) cases over successive epidemic periods in Tunisia.

Rhinoviruses (RV) are a major cause of Severe Acute Respiratory Infection (SARI) in children, with high genotypic diversity in different regions. However, RV type diversity remains unknown in several regions of the world. In this study, the genetic variability of the frequently circulating RV types in Northern Tunisia was investigated, using phylogenetic and phylogeographic analyses with a specific focus on the most frequent RV types: RV-A101 and RV-C45.

First Tunisian Cluster Admissions of Critically Ill Patients with Multisystem Inflammatory Syndrome in Children (MIS-C).

Background: Multisystem inflammatory syndrome in children (MIS-C) is a new emerging severe disease that is temporally related to previous exposure to coronavirus infection disease (COVID-19).

Aim: To describe the clinical features, laboratory findings, therapies, and outcomes for the first Tunisian cluster admissions of critically ill children with severe MIS-C.

Methods: Retrospective study conducted from November 01 to November 30, 2020According to the WHO definition case, we included eight children aged less than 15 years who were admitted to our pediatric intensive care and met MIS-C criteria.

Evaluation of the influenza-like illness surveillance system in Tunisia, 2012-2015.

Background: This study was initiated to evaluate, for the first time, the performance and quality of the influenza-like illness (ILI) surveillance system in Tunisia.

Methods: The evaluation covered the period of 2012-2015 and used different data sources to measure indicators related to data quality and completeness, representativeness, timeliness, simplicity, acceptability, flexibility, stability and utility.

Results: During the evaluation period, 485.

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.

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.

Prevalence of Bordetella pertussis and Bordetella parapertussis infections in Tunisian hospitalized infants: results of a 4-year prospective study.

The prevalence of pertussis in Tunisia remains undetermined essentially because of the unavailability of a basic laboratory diagnostic service. Specific diagnostic tools were applied for the first time in a Tunisian prospective study in order to get a first estimation of the prevalence of Bordetella pertussis/parapertussis infections and to evaluate their use to determine the epidemiologic characteristics of these infections in Tunisian infants. Between 2007 and 2011, a total of 626 samples from 599 infants aged <1 year with and without pertussoid cough were investigated for the presence of B.

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).

Datura stramonium L. poisoning in a geophagous child: a case report.

Datura stramonium L. (DS) is a wild-growing plant widely distributed and easily accessible. It contains a variety of toxic anticholinergic alkaloids such as atropine, hyoscamine, and scopolamine.

The new health legacy: when pertussis becomes a heritage transmitted from mothers to infants.

Despite high vaccination coverage rates, there has been a gradual increase in reported pertussis cases. Although whooping cough affects all ages, young infants continue to suffer the greatest pertussis disease burden. Adolescents and adults are the primary source of infection for young babies.

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.