[Recurrences of acute rheumatic fever in Tunisian children. Apropos of 100 cases].
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Biomedical subjects
Publications and source records attributed to J J Kuss.
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A congenital carotid--jugular aneurysm was responsible for severe heart failure in a two day old baby. The child recovered after surgery. The signs suggesting an arteriovenous fistula (a continuous murmur and thrill, hyperdynamic circulation) may be absent, as in this case, when the child is in severe cardiac failure. The signs should be sought when the circulation improves.
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The periphery of the retina was examined with the use of contact lenses at the age of 5 years in children who were born prematurely and weighed less than 1,500 g at birth. In this retrospective series 65% of the children were found to have lesions similar to the classical findings in retrolental fibroplasia although only to a minor degree. Low oxygen levels with a short duration of the exposure cannot completely prevent these sequalae. This retinopathy which is limited to the periphery, may account for the frequency and severity of myopia in children who were premature. Later in childhood and more rarely retinal detachment or tears may occur which cause severe visual impairment.
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The retinal periphery of 60 premature children now between 5 and 8 years of age and with a weight at birth equal or less than 1,500 g has been investigated. In 20% of these children, pigmentary modifications were noted which were often associated with chorioretinal atrophy. Polymorphic vascular abnormalities were seen in 14% of the cases, i.e. sinuous vessels of irregular caliber or neovascularization. Abnormalities of the vitreous body were also noted in 12% of the patients with glial bags on the periphery and sometimes potentially dangerous tractions folds (4%). All these abnormalities could cause complications such as retinal tear, retinoschisis or retinal detachment. Even if these signs are discrete, they can later on be the source of complications. Refraction studies revealed 30% of myopic children. The most important group had myopias equal or higher than 8 d. The characteristics of the myopia of premature children are its constancy (all premature children are myopic at birth); its importance (it depends on birth weight and on the severity of the retinopathy), and its evolution (the myopia of premature children does not evolve or evolves very slightly).
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Case report of a 8 month-old North-African infant with liver amebiasis. This disease is not rare in young children and may be observed in all endemic zones of amebiasis. The clinical characteristics, special for the age, and the biological features are reviewed. The diagnosis relies on immunological tests. Treatment is essentially medical, metronidazole often being effective.
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An eight week old baby who presented with a cholestatic jaundice had a bile plug in the ampulla of Vater. The plug was removal via a transduodenal approach. The bile plug syndrome is a rare cause of extrahepatic biliary cholestasis and is different from the inspissated bile syndrome in which the involvement is predominantly hepatocellular.
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