Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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Clonidine poisoning's clinical feature is well documented in the medical literature, but the minimal toxic dose has not yet been established. The effectiveness of naloxone is also controversial. ⋯ By maintaining the Trendelenburg position, administering fluids as well as salbutamol and naloxone (three doses of 0.2 mg were required), he recovered and was discharged from the hospital on day 2. The minimal clonidine toxic dose, the clinical picture, and the effectiveness of naloxone administration are discussed in this paper.
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Although less frequent than viral encephalitis, anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a frequent form of acute pediatric encephalitis. After a prodromal phase of flu-like symptoms, psychiatric symptoms predominate - agitation, anxiety, hallucinations - and can make correct diagnosis more difficult. ⋯ Although the CSF abnormalities are not highly specific of this disease, and MRI most often normal, EEG shows more specific signs. These observations enable us to discuss different treatment options and understand the progression of this disease.
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Group A streptococcus (GAS) is the most frequently identified bacterium in children with acute pharyngitis. Clinical signs and symptoms cannot distinguish accurately between viral and GAS pharyngitis. Rapid antigen detection tests (RADTs) can identify GAS by an immunologic reaction within a few minutes. ⋯ Available evidence suggests that clinical prediction rules for the triage of children who should undergo GAS testing are not sufficiently accurate. Implementing RADTs into clinical practice has an important impact on antibiotic prescription rates, for a reduction of about 30 %. French guidelines that recommend using RADTs in all children above 3 years of age presenting with pharyngitis without backup culture of negative tests seem relevant in this context.