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Summary: Pertussis is ranked among the leading causes of childhood mortality. The most catastrophic clinical complication of pertussis in infants, intractable pulmonary hypertension with shock, is not very well known. We describe the clinical course of a fatal case of severe pertussis complicated by refractory pulmonary hypertension and shock in a 2-month-old infant. [ABSTRACT FROM AUTHOR]

Introduction: Les méningites restent un problème préoccupant de la santé au Maroc, malgré les progrès thérapeutiques du fait de la mortalité élevé et des séquelles neurosensorielles. Le but de travail: Analyser le profil épidémiologique, clinique, biologique et la prise en charge thérapeutique des méningites. Matériel et Méthodes: Nous rapportons les résultats d’une étude rétrospective menée au service de pédiatrie durant l’année 2009, colligeant les différents types de méningites. Résultats: Nous colligeons 88 cas, 58 garçons et 30 filles, dont l’âge varie de 3 mois à 14 ans. Cliniquement, 17 malades ont été admis dans un tableau de convulsion avec fièvre, 38 présentaient des taches purpuriques. La ponction lombaire a trouvé un LCR clair chez 32 malades,et purulent chez 41malades. Les méningites bactériennes représentent 75 % des cas. L’étude bactériologique a confirmé 9 cas de méningites à méningocoque, 7 cas à pneumocoque et 1 seule à Hémophilus influenzae. Les méningites virales représentent 25 % des cas. L’évolution été favorable dans la majorité des cas avec 7 cas d’hydrocéphalie, 4 cas d’empyème cérébral, et 2 cas de thrombophlébite cérébrale. On déplore un décès. Conclusion: Les méningites restent fréquentes dans notre contexte d’où l’intérêt de la prophylaxie et de la vaccination. [ABSTRACT FROM AUTHOR]

Summary: Objective: The group B streptococcal meningitis (GBS) remains an important cause of child''s morbidity and mortality. The purposes of this work were to appreciate the GBS place among the bacterial meningitis, to define clinical and biological factors associated with death and to study the immediate complications. Patients and methods: This study concerned 276 GBS meningitis listed by the observatory of GPIP/ACTIV on the child''s bacterial meningitis in France from January, 2001 to December, 2005. This report is one of the biggest series of child''s GBS meningitis published to this day. Results: The GBS was the third germ in frequency responsible for bacterial meningitis at every age (13 %) : 65 % of the GBS meningitis affected infants less than one month of age, 29 % infants between 1 month and 3 months of age and only 6 % infants more than 3 months of age. The male/female ratio in GBS meningitis was nearly equal (51 % vs 49 %). There was no variation of the GBS meningitis number according to the season. The serotype III was mostly involved in this cohort (81 %) followed by the serotype I (13 %). Statistically we observed a significant decline in the number of early onset meningitis from 2001 to 2004 whereas the number of late meningitis and the total meningitis cases were stable. The biological results mostly present in child''s GBS meningitis were a high CSF protein level (95 %), a CSF neutrophil count more than fifteen percent (90 %), a low CSF glucose level (83.5 %), leukopenia (49 %) or a normal blood level leukocyte (38 %). Eighty three percent of the children affected by GBS meningitis were term infants. However, the prematurity seemed to be a risk factor to develop late meningitis (age between 7 days and 3 months) and very late meningitis (after 3 months) but no early onset meningitis. Prematurity, convulsions, shock, coma, assisted ventilation, high CSF protein level, weak CSF cell level and leukopenia seemed to be factors associated with death in the GBS meningitis. The mortality of the GBS meningitis was still 14 % and the immediate complications were observed in 62 % of cases, the most frequent being convulsions (45 %). Conclusion: The GBS meningitis in children remains a frequent problem in pediatrics despite intra partum antibioprophylaxy and thus must encourage to strengthen the prevention of these meningitis. [Copyright &y& Elsevier]