Introduction: Defined by the WHO as all the pathological manifestations following ingestion of food or the administration of products or drugs behaving like a poison in the body, acute intoxication is a growing problem. serious in pediatrics, in developing countries because of their frequency and the difficulties of care. In Mali, poisoning in children is very poorly assessed, in part due to the lack of popularization of poison control and pharmacovigilance centers. The objective of our study is to study the epidemiological and clinical aspects of acute poisoning in children in the emergency department of the pediatric department of the Gabriel Touré University Hospital. Material and methods: We carried out a retrospective, cross-sectional and descriptive study from January 2016 to December 2018, or a period of 3 years. It concerned children from 1 month to 15 years old hospitalized in the pediatric emergency room of the Gabriel Touré University Hospital for proven acute poisoning. The data were collected by: a pre-established individual survey form, information contained in the medical files of patients after the approval of the Head of the Department. Results: During our study period, 80 children were hospitalized for acute poisoning out of a total of 5,437, a frequency of 1.47%. The sex ratio was 1.3. The 13-48-month age group accounted for 65% of cases. The patients themselves were responsible for their poisoning in 74.2% of cases. Poisoning by unspecified drugs accounted for 25% of cases. The oral route represented 92.4% of the poisoning routes. Ingestion of milk (29.9%) and oil (6.3%) were the most common actions for parents. Vomiting with 35% and respiratory distress with 35% were the most frequent manifestations. The mean hospital stay was 3.5 days (50%). In 50% of cases, death occurred within the first 24 hours. Conclusion: Poisoning remains a common occurrence in our department, mainly linked to several medicines and household products.
Fournier's gangrene is a form of necrotizing fasciitis that has multiple causes and is relatively uncommon in children. We report a case of Fournier's gangrene of infectious origin in a 12-month-old infant following an insect bite. A rapid diagnosis and multidisciplinary care saved the patient.
Introduction: Children's heart disease is a major public health problem in developing countries and especially in Mali. The purpose of our work was to determine frequency, different types of heart disease and their short term evolution in the pediatric department. Methods: We performed a retrospective study among children aged 0 to 15 years, hospitalized in the pediatric department from January to December 2015 and whose diagnosis was confirmed using trans-thoracic echocardiography. Results: We included 103 cases of heart disease out of a total of 8613 admissions in the pediatric department, giving an hospital prevalence of 1.2%. Mean age was 4.1 years (from 1 day to 15 years) and children under 5 years were the most affected with 73.80% of cases. Male predominance was noted (sex ratio = 1.2). Respiratory distress was the most common circumstance of discovery (93.20%). Cardiac murmur and tachycardia were the most common cardiac signs with respectively 88.35% and 83.50%. Congenital heart disease accounted for 70.87% and was dominated by ventricular septal defect (VSD) with 30.13%. Acquired heart disease (29.13% of the sample) was dominated by mitral regurgitation (MR) with 56.67%. Mortality rate was 31.9% for congenital heart disease and 11.1% for acquired heart disease. Conclusion: children's heart disease is responsible for high mortality. Early detection improves the management of this pathology, which remains frequent.
Introduction: Toxic epidermal necrolysis (TEN) or Lyell syndrome is the most severe form of toxidermia. It is clinically characterised by a generalised exanthema with a skin detachment of more than 30% of the body surface area, which differentiates it from Stevens-Johnson syndrome (SJS), which affects less than 10% of the body surface area. Its management is essentially symptomatic. The aim of our study is to investigate the clinical, therapeutic and evolutionary aspects of Lyell syndrome. Materials and Method: We conducted a retrospective prospective cross-sectional and descriptive study over a period of 5 years (from 1 January 2014 to 31 December 2018). It concerned children from 1 month to 15 years old. Data were collected using a pre-established survey form and inpatient records. After informed consent from parents and the Head of Department, all information was collected in strict confidentiality. Results: During the study period, we were able to collect 10 patients meeting our inclusion criteria out of 9050 hospitalizations, or a frequency of 0.11%. The sex ratio was 4. The age group (6 months to 5 years) was the most affected with 60% of cases. Almost all patients (90%) consulted for skin lesions. The drugs frequently incriminated were non-steroidal anti-inflammatory drugs and anti-epileptics in equal proportions (20%). In 4 patients (40%), no drug could be clearly incriminated. On physical examination, NIKOLSKI's sign was found in 90% of patients. Management was essentially based on rehydration, antibiotic therapy, analgesics and local care. However, mortality remains very high (7 out of 10 patients). Conclusion: A rare but very serious pathology, Lyell syndrome has a poor prognosis in our context.
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