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Biomedical subjects

G de Bilderling

Publications and source records attributed to G de Bilderling.

14 recordsLinked to original sources
PubMed2006

[Necrotizing pneumonia in children: apropos of 4 cases].

OBJECTIVES: To describe the necrotizing pneumonia in children, a severe affection which prevalence seems to increase; to review literature. PATIENTS AND METHODS: We report 4 cases of necrotizing pneumonia: symptoms, agents, diagnostic tools, treatment and long term evolution. RESULTS: In 2 cases, pneumatoceles could be seen at chest X-ray. Two patients presented a deficiency of anti-pneumococcal antibodies. Three needed insertion of a pleural chest tube of whom 1 had a resection of a small piece of necrotic lung. Duration of hospitalisation is longer than in uncomplicated pneumonias. CONCLUSION: Necrotizing pneumonia is a severe affection. Diagnosis has to be made by lung CT. Long term evolution is excellent in pediatric population with serious management at hospital.

Adolescent↗
PubMed2006

[Pleural effusion in childhood: management algorithm].

Based on an increased prevalence of empyema in children,we reviewed the literature on the diagnosis and management of this affection. A retrospective study of 11 children admitted to our hospital in 2003 shows a prolonged hospitalisation (median 18 days) even with adequate treatment. Based on our experience and data from the literature, we propose a management algorithm to allow treatment of children admitted ith pleural effusion.

Age Factors↗
PubMed2001

[Laryngitis revealing bacterial tracheitis in a five-year-old child].

CASE REPORT: We report the case of a five-year-old boy with clinical features of croup and left lower lobe pneumonia. Response to inhaled adrenaline and dexamethasone was incomplete and he developed respiratory distress. Direct laryngoscopy performed in the operating room showed mild glottic and subglottic inflammation. On bronchoscopy, there was thick pus coming from the left lower lobe. He was intubated for three days and regular toilet brought back thick pus. Tracheal fluid culture grew Haemophilius influenzae. COMMENTS: We suggest that he had bacterial tracheitis but that the tracheal involvement was not prominent at the time of diagnosis. CONCLUSION: Laryngoscopy and bronchoscopy in specialized surroundings should be considered for each child with croup unresponsive to conventional treatment, especially in case of lower respiratory tract involvement.

Administration, Inhalation↗
PubMed2001

Cutaneous lesions of disseminated cryptococcosis as the presenting manifestation of human immunodeficiency virus infection in a twenty-two-month-old child.

We report the case of a 22-month-old African boy with cutaneous lesions as the predominant feature of disseminated cryptococcosis (positive blood and cerebrospinal fluid cultures) and as the presenting manifestation of severe vertically acquired HIV infection (CDC C3 category). To our knowledge these cutaneous lesions have never been reported as the initial manifestation of AIDS in children.

AIDS-Related Opportunistic Infections↗
PubMed2001

[Asthma in the young child: when should inhaled foreign body be suspected?].

Many young children and infants wheeze during viral infections of the respiratory tract. The differential diagnosis of those children includes the inhalation of a foreign body. This diagnosis is overlooked in about 20% of cases, which leads to subacute and chronic complications. Two clinical observations are reported, involving young children with clinical asthma exacerbations but where the absence of response to usual treatment and/or the absence of evidence for atopy and/or the acute onset brought us to suspect the inhalation of a foreign body. These cases allow us to remind the usual signs and symptoms associated with the inhalation of a foreign body. Amongst these signs, unilateral hypoventilation on chest auscultation associated with localized emphysema on chest x-ray has a very high positive predictive value. Aggressive management in a specialized surrounding is advocated when an inhaled foreign body is suspected. Algorithms based on the level of suspicion have been designed to allow the pediatric respiratory physician to choose between rigid and fiberoptic bronchoscopy. It is only by systematization of these procedures and development of preventive measures that we will be able to reduce the prevalence of complications secondary to the inhalation of a foreign body.

Algorithms↗
PubMed1999

[Spontaneous pneumomediastinum in an adolescent: an underestimated cause of chest pain].

CASE REPORT: A case of mediastinal emphysema occurring without etiologic factor except a Valsalva's manoeuvre a few hours before admission in a 15-year-old boy is reported. Symptoms were cervical and chest pain with moderate dysphagia. Diagnosis was confirmed by palpating subcutaneous air in the neck region and mediastinal air on a chest roentgenogram. A CT scan was performed to exclude a concurrent pneumothorax. The patient recovered with bed rest. CONCLUSION: Spontaneous pneumomediastinum results from nontraumatic, mediastinal air leakage without underlying lung disease. It should be considered in the differential diagnosis of chest pain, especially in healthy adolescents and young adults; it is certainly underdiagnosed in this population.

Adolescent↗
PubMed1999

Foreign body aspiration in childhood: management algorithm.

Foreign body inhalation is still a major cause of morbidity and even mortality in the under-fives. To reduce its frequency, more severe preventative measures must be imposed and to allow for early diagnosis, a low threshold for bronchoscopy is necessary. This retrospective study is based on 33 children referred to us for suspicion of inhaled foreign body. Symptomatology, clinical and paraclinical data are reviewed. Based on our practice and on the experience gained from the literature, we propose a management algorithm which will need to be further assessed by a prospective study.

Algorithms↗
PubMed1999

[Urinary infection in the child: diagnosis, treatment, and prognosis].

Urinary tract infection is a common paediatric disease. Pyelonephritis may lead to severe renal damage (renal scarring), with possible arterial hypertension and renal insufficiency. Treatment and prognosis are closely related to a number of risk factors such as clinical, biological, radiological and scintigraphic data. The aim of the management is to give the most appropriate treatment and follow-up to avoid renal scarring.

Child↗
PubMed1993

[Recurrent respiratory distress and idiopathic subglottic stenosis: what treatment?].

BACKGROUND: Idiopathic subglottic stenosis is a rare cause of acute respiratory distress, that is difficult to treat (corticosteroids, tracheotomy). CASE REPORT: A nine-year-old boy presented with acute respiratory distress due to tracheal stenosis. The symptoms recurred after the endotracheal inflammatory membranes had been removed with forceps, despite 6-months of degressive corticotherapy. Absence of other causes of tracheal stenosis and biopsies led to diagnosis of idiopathic subglottic stenosis. The patient was treated by CO2 laser followed by degressive corticotherapy. The respiratory distress recurred within 3 months of discontinuing corticosteroids, requiring two further CO2 laser treatments. The patient became corticodependent. CONCLUSIONS: CO2 laser is an effective, wise alternative treatment of acute respiratory distress due to idiopathic subglottic stenosis that can be repeated if necessary.

Acute Disease↗
PubMedDate not supplied

Bronchiolitis management by the Belgian paediatrician: discrepancies between evidence-based medicine and practice.

UNLABELLED: There is no therapy with proven effect on bronchiolitis outcome. This leads to large variations in its management between different countries. In order to evaluate how this disease was managed in our country, a questionnaire was sent to all Belgian paediatricians. With a response rate above 40% of active paediatricians, we found that bronchodilators (74.7% vs. 77.2%), physiotherapy (76.2% vs. 85.6%) and antibiotics (63.8% vs. 74.4%) were still largely prescribed in in- and outpatient settings respectively, corticosteroids (orally or intravenously) being prescribed more often in hospitals (54.3% vs. 17.0%). There were also some variations in admission criteria (minimal age 2 months (75%) to 6 months (8.2%), lower limit for oxygen saturation: 90% (21.5%) to 95% (26.5%)) and 1/3 of the respondents did not use pulse oxymetry to evaluate hypoxaemia in infants with bronchiolitis. Logistic regression analyses allowed us to identify patterns of prescription based on age, type and level of activity and language. CONCLUSION: Many therapies with no proven effect are still used by Belgian paediatricians to treat children with bronchiolitis. Based on these results, we believe that publishing national guidelines will allow a reduction in the cost associated with this disease.

Administration, Inhalation↗