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Sarcoidosis is rare in children and may present misleading appearances. Authors report the case of 13-years-old child explored for prolonged fever, inflammatory syndroma and skin lesions. Abdominal ultrasound showed hepatomegaly, mesenteric lymphadenopathy and splenic nodule. Chest CT scan demonstrated bilateral hilar adenopathy. Histology of inguinal adenopathy concluded to a caseo-follicular tuberculosis. Sarcoidosis was suspected after tuberculous treatment failure, persistent high fever, negative tuberculin test and skin biopsy results. This diagnosis was reinforced by bronchoalveolar lavage results, high level of angiotensin converting enzyme and histological control. Favourable evolution was noted with a high dose corticotherapy.Sarcoidosis, though rare in children, should be suspected when prolonged fever is associated with important inflammatory syndroma. [Copyright &y& Elsevier]

Introduction Les pneumopathies infiltrantes diffuses chroniques (PIDC) chez l’enfant sont peu étudiées en Tunisie. Nos objectifs étaient d’analyser leurs étiologies ainsi que les caractéristiques cliniques et évolutives relatives à chaque étiologie. Patients et méthodes Notre étude était rétrospective incluant tous les patients ayant une PIDC quels que soient sa cause et les suivis dans le service de médecine infantile B de l’hôpital d’Enfants de Tunis de 2010 à 2015. Étaient exclues les suspicions de PIDC sans confirmation tomodensitométrique. Résultats Les PIDC de nos 8 patients étaient en rapport avec : un déficit en protéines du surfactant (DPS) ( n = 4), une protéïnose alvéolaire primitive (PAP) ( n = 2), et une sarcoïdose (S) ( n = 2). Les patients âgés en moyenne de 30 mois (3 mois–10 ans). Les circonstances de découverte étaient une pneumopathie traînante dans 3 cas, des broncho-pneumopathies récidivantes avec oxygéno-dépendance dans 3 cas, et des adénopathies cervicales avec une fièvre prolongée dans 2 cas. La TDM thoracique montrait une pneumopathie interstitielle diffuse dans tous les cas. Tous les patients ont eu un LBA. Une biopsie pulmonaire a été pratiquée chez les 4 patients atteints de DPS. Le traitement reposait sur la corticothérapie ( n = 6) ± OLD ( n = 4). Les 2 cas de PAP ont eu des LBA thérapeutiques avec une guérison dans un cas (recul de 4 ans). Conclusion Étant méconnues, les pathologies liées aux protéines du surfactant (DPS et PAP) étaient de diagnostic tardif. Leur pronostic était variable. La sarcoïdose, observée chez le grand enfant, était caractérisée par des manifestations extra-respiratoires rares. [ABSTRACT FROM AUTHOR]

Abstract: Background: Rotaviruses are the most frequent agents associated with diarrhoea in children worldwide. Analysis of mobility of the 11 segments of genomic RNA by polyacrylamide gel electrophoresis (PAGE) yields a pattern which is characteristic for a particular rotavirus isolate. The group A rotaviruses can be further characterized by analysis of VP7 and VP4 genes specificities, responsible for rotavirus classification into G and P genotypes, respectively. The aim of the present study was to determine the evolution of group A Rotavirus strains circulating in Tunisia over a 3-year period (2005–2007). Material and methods: A total of 1503 stool samples collected from children less than five years old, consulting or hospitalised in Tunisia for diarrhoea between 2005 and 2007, were screened for the presence of group A Rotaviruses. Rotavirus-positive specimens were further analyzed by PAGE and G/P-genotyped by multiplex semi-nested RT-PCR. Results: Rotaviruses were detected in 323 stool samples over 1503 (21 %). Long electropherotypes predominated in Tunisia during the whole period of study (N =158 vs N =82 short electropherotypes). VP7 genotyping showed the cocirculation of five different genotypes: G1, G2, G3, G4 and G9. VP4 typing detected four different P-genotypes: P[8], P[4], P[6] and P[11]. Rotavirus strains with G3P[8] specificity were predominating in Tunisia in 2005 and 2006, replaced by G2P[4] strains in 2007. [Copyright &y& Elsevier]

Abstract: Background: Rotaviruses are the most frequent agents associated with diarrhoea in children worldwide. Analysis of mobility of the 11 segments of genomic RNA by polyacrylamide gel electrophoresis (PAGE) yields a pattern which is characteristic for a particular rotavirus isolate. The group A rotaviruses can be further characterized by analysis of VP7 and VP4 genes specificities, responsible for rotavirus classification into G and P genotypes, respectively. The aim of the present study was to detect a relationship between electropherotype pattern and molecular characteristics of the rotavirus strains. Material and methods: Were analyzed 278 rotavirus-positive specimens by PAGE and G/P-genotyped by multiplex semi-nested RT-PCR. Pearson''s correlation tests were used for statistical analysis. Results: Twelve different electropherotypes were visualized, eight with a long profile (186 cases) and four with a short one (87 cases). Concerning VP7 types, G2 viral strains were found to be predominant and were detected in 91 specimens (32.7%). Strains with G1, G3, G4, G8 and G9 specificities were detected in 62 (22.3%), 82 (29.5%), 13 (4.7%), two (0.7%) and seven cases (2.5%), respectively. The results of VP4 genotyping showed a predominance of P[8] genotype which comprised half of the strains identified (139 cases, 50%). VP4 P[4], P[6] and P[11] were found in 83 (29.9%), 31 (11.1%) and 11 (4.0%) specimens, respectively. A high rate of mixed strains was also found (1.8% mixed electropherotypes, 7.6% G-mixed and 5% P-mixed strains). Electropherotype pattern of rotavirus strains was significantly correlated with VP7 genotype (p =0.018) and with VP4 genotype specificities (p <0.001). [Copyright &y& Elsevier]