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Rhinosinusitis in children is mainly caused by virus. After medical examination and according to the evolution, two clinical situations are defined: sub acute and persisting rhinosinusitis or acute and severe rhinosinusitis. Due to the development of sinus cavities, location of rhinosinusitis varies with age, ethmoïditis being the first location in young child. Imaging is recommended in cases of severe symptomatology or extra maxillary locations or for complications. Antibiotherapy is recommended in severe cases or complications. The choice of drugs is supported by the bacterial epidemiology of these infections and the level of resistance in France of the different microorganisms involved. In other cases, management includes symptomatic treatment and obvious informations on the different modalities of evolution.

Acute diarrhoea is one of the major causes of outpatient paediatric consultation, especially during infancy. An infectious cause should be suspected on the acute onset of diarrhoea associated with fever. The specific pathogen is seldom investigated and individualized. Rotavirus has been recognized as the most important enteric pathogen, particularly in infants during winter months. It may be responsible for nosocomial infections in hospital and outbreaks in day-care centers. Bacteria may cause a diarrhoea by elaboration of enterotoxins, by invasiveness, or both. Use of antibiotic is usually not necessary even in bacterial infections because they are self-limited. Choice of the antibiotic is complicated by the rapid emergence of resistant pathogenic strains. The first step is rapid assessment of the hydratation status of the patient. Fluid and electrolytes replacement is the mainstay in the treatment of infectious diarrhoea of any cause.

All children returning from countries where parasitic diseases are endemic should be investigated for one or several of these diseases according to the region visited and the duration of the visit. Investigations should include at least a parasitological examination of the stools, sometimes completed by a search for urinary schistosomiasis and, at the slightest suspicion, an examination of the eye. The gastrointestinal and percutaneous modes of transmission of parasitoses are such that children are particularly at risk. The most frequently encountered diseases are ankylostomiasis, anguilluliasis, amoebiasis, urinary schistomiasis and filariasis. Side by side with these strictly tropical parasitoses, one may find massive infestation with ascarides and lamblias. Effective and well tolerated treatments are available for most of these diseases, but advice on prophylactic measures is essential to reduce the risk of contamination.

The management of children with sickle-cell disease in specialized centres may take place either during the intercritical phase of the disease or in the period of vaso-occlusive phenomena and acute complications. Without any doubt, a regular follow-up of these children, starting immediately after the diagnosis is made, improves the prognosis. Repeated visits enable the physician to inform the family and thereafter the child on the disease, its consequences and its transmission and to implement such prophylactic measures as preventive antibiotic therapy, specific immunizations and advice on hydration. As years go by, this monitoring is modified according to the patient's age, the course of the disease and the age-related complications. Acute accidents are frequent and often difficult to diagnose. In the immediate and well-adjusted management they require rehydration, rest, analgesics and antibiotics play a major role. The purpose of management is to avoid most complications and raise the child to adulthood in the best possible conditions.