Fifty-one children with the initial attack of acute rheumatic fever (ARF) were studied prospectively to verify the sociodemographic and clinical profile and to compare results with those from other countries. Most children belonged to large families who lived in an urban setting with ready access to medical care. Unlike reports from many developing countries, the clinical manifestations in this study paralleled data from the West and included arthritis in 76% of the cases, carditis in 43%, and chorea in 8%. Among the 22 cases with carditis, 18 had mitral regurgitation, three developed combined mitral and aortic regurgitation, and one had aortic regurgitation. This study demonstrates the mild nature of ARF in Saudi Arabia and supports the concept that climate and geography appear to bear little relationship to the incidence and severity of ARF.

SUMMARY Of 215 Saudi children seen with their first febrile convulsion (FC) at the King Khalid University Hospital, Riyadh, between January 1984 and December 1988, the index FC was simple for 133 children and complex for the remaining 82. History of adverse antecedent factors, particularly perinatal asphyxia, birth injuries and pre‐existing neurological deficits, were significantly more associated with complex FC, as was occurrence of first FC before the age of 12 months. Recurrence of FCs and development of epilepsy were also more common among the group of children with complex FC. Complex FCs were less benign in the present study population than has been reported in some Western studies. RÉSUMÉ Antécédents et devenir des convulsions fébriles simples et complexes farmi les enfants saoudiens Parmi 215 enfants saoudiens avec une première convulsion febrile (FC) vus au King Khalid University. Hospital de Riyadh entre Janvier 1984 et decembre 1988, l'index (FC) fut simple pour 133 enfants et complexe pour les 82 restants. L'histoire de facteurs extérieurs défavorables notamment une asphyxie périnatale, des lésions à la naissance et des déficits neurologiques pré‐existants était significativement davantage associée avec des FC complexes, lorsque la première FC se situait avant l'âge de 12 mois. La récidive des FC et le développement d'une épilepsie étaient également plus fréquents dans le groupe des enfants avec FC complexes. Les FC complexes sont apparus moins bénignes dans l'étude de population présente qu'il n'avait été rapporté dans quelques études occidentales. ZUSAMMENFASSUNG Initialsymptome und Verlauf einfacher und komplexer Fieberkrämpfe bei saudischen Kindern Von 125 saudischen Kindern, die im König Khalid Universitätskrankenhaus in Riad von Januar 1984 bis Dezember 1988 wegen ihres ersten Fieberkrampfes (FC) behandelt wurden, hatten 133 einen einfachen und die restlichen 82 einen komplexen Fieberkrampf. Bei Kindern mit komplexem FC fanden sich in der Anamnese signifikant häufiger pathologische Vorbefunde, wie perinatale Asphyxie, Geburtsverletzungen und schon bestehende neurologischen Störungen, sowie sie häufiger ihren ersten FC im ersten Lebensjahr hatten. Rekurrierende FCs und Entwicklung von Epilepsie waren bei den Kindern mit komplexem FC ebenfalls häufiger. Die komplexen FCs waren bei den hier untersuchten Kindern weniger gutartig als dies in einigen westlichen Untersuchungen dargestellt wurde. RESUMEN Antecedentes y curso posterior de las convulsiones febriles simplesy complejas en niños de Arabia Saudi De 215 niños Saudies vistos por su primera convulsion febril (CF) en el Hospital Universitario Rey Khalid en Riyadh entre enero de 1984 y diciembre de de 1988, 133 tenían una CF simple y el resto de 82 la tenían compleja. Una historia de factores antecedentes adversos, en especial asfixia perinatal, lesiones del parto y deficits neurológicos preexistentes estaban mas asoctados signoficativamente con CF complejas asi como la aparición de la primera CF antes de los 12 meses de edad. La reiteración de l...

Purpura fulminans is a critical, mostly fatal, thrombotic syndrome that requires urgent intervention. Purpura fulminans is an acute purpuric rash characterized by coagulation of the microvasculature, which leads to purpuric lesions and skin necrosis. In this report, we present a rare case of an adult patient who was admitted with rapidly forming purpura fulminans in an uncommon location.

A cross-sectional study was carried out to determine the prevalence of iron deficiency among healthy Saudi children from birth to 15 months of age. The groups studied were: newborns, 3-4 months, 5-6 months, 7-8 months, 9-10 months and 12-15 months of age. The age groups were dictated by the vaccination schedule. Serum ferritin was measured and transferrin saturation calculated in each subject. The lower limits of normal were taken as a transferrin saturation of less than 10% and a serum ferritin of less than 12 micrograms/l. A total of 333 serum samples was adequate for analysis. None of the newborns or the 3-4-month-old infants had evidence of iron deficiency. At 5-6 months only 3.3% of subjects had iron deficiency. In the subsequent older age groups the prevalence of iron deficiency increased significantly with age from 9.3% to 12.7% and reached 14.5% in the oldest age group. Screening for iron deficiency in children attending well-baby clinics and hospitals at ages of 12-15 months is recommended.

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