Archives françaises de pédiatrie
-
In children, Pneumocystis carinii pneumonias occur mainly in cases of congenital or acquired immunodeficiencies. Definitive diagnosis rests on the visualization of the parasites, ideally by broncho-alveolar lavage. If the lavage is negative and the patient deteriorates, an open lung biopsy is the next best diagnostic method. ⋯ Treatment with trimethoprim-sulfamethoxazole (TMP) should be instituted as early as possible: a serum level of TMP between 5 and 10 micrograms/ml should be attained. If no improvement occurs after three days, pentamidine should be substituted. Systematic chemoprophylaxis should be given to all high-risk patients.
-
Neonatal lupus syndrome can be considered as being associated with pregnancy in women with lupus. Two antinomic cases are reported: a pregnancy in a woman presenting with Sjögren's syndrome, bearing a child with neonatal lupus syndrome (atrioventricular block and antinuclear antibodies) and a pregnancy in a woman presenting with lupus and giving birth to a normal child with antinuclear antibodies. These 2 case reports allow us to speculate on the pathophysiology of neonatal lupus syndromes in which the type of antinuclear antibodies seems to play a major role.
-
The authors report 2 cases of spontaneous pneumomediastinum observed in 2 male children aged 11 and 9 years respectively, during a bout of diabetic ketoacidosis. This association is probably not uncommon. The course of the pneumomediastinum is usually rapidly favorable. Its pathogenesis is discussed.