Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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Periodic fever is defined as a series of unexplained febrile episodes, most often starting during childhood. The febrile episodes last usually few days, are of fixed or variable duration, and regress spontaneously, the intervals between episodes being asymptomatic. Fever is accompanied by clinical manifestations affecting peritoneal, pleural and/or mucous membranes, joints and skin. ⋯ Three are hereditary diseases: familial mediterranean fever and periodic fever with hyperimmunoglobulinemia D which have a recessive autosomal transmission, and TNF receptor associated periodic syndrome or TRAPS which has a dominant autosomal transmission. One is sporadic: periodic fever with aphthous stomatitis, pharyngitis and adenopathy or PFAPA. Other etiologies are yet to be identified as many cases of periodic fever remain unexplained.
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This prospective study was designed to identify risk factors associated with admission in pediatric intensive care units (PICU) among infants hospitalized for treatment of RSV induced bronchiolitis. This study was population-based and was conducted in Burgundy, a French region with 1,800,000 inhabitants where passive immunoprophylaxis for RSV bronchiolitis was not set up at the time of the study. ⋯ This study suggests that population at risk for severe RSV bronchiolitis with PICU admission should include all very preterm infants with RDS whatever the outcome of RDS (with or without BPD). These epidemiological data could be helpful to set up indications for passive immunoprophylaxis of RSV induced bronchiolitis.
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Case Reports
[Severe Reye syndrome: report of 14 cases managed in a pediatric intensive care unit over 11 years].
Idiopathic Reye syndrome is a rare disease revealed by unexplained encephalopathy and microvesicular liver steatosis. Some clinical and epidemiological studies mainly performed in English speaking countries questioned the reality of Reye syndrome because numerous know inherited metabolic diseases, and some of them unrecognized, could mimick this disorder. We focused in our study on severe forms of Reye syndrome admitted to a pediatric intensive care unit. ⋯ Unlike widespread opinion, severe Reye syndrome without identified metabolic disorders seems to not disappear in our country. Reye syndrome remains a potentially life threatening disease and raises for aggressive treatment of brain edema. If aspirin and Reye syndrome association are not formally documented in France, cautiousness must be kept in mind and all the aspirin adverse effects notifications should be addressed to the public drugs survey network.