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1. Critically ill infants with SARS-COV-2 delta variant infection

Author

Aida Borgi, Assaad Louati, Amal Miraoui, Lilia Lahmar, Ahmed Ayari, Ahmed Hajji, Asma Bouziri, Khaled Menif, Hanen Smaoui, and Nejla Ben Jaballah

Subjects
acute respiratory distress syndrome, delta variant, intensive care, mechanical ventilation, SARS-CoV-2, Pediatrics, RJ1-570
Abstract

Background: SARS-CoV-2 is described to cause mild to moderate symptoms in children. To date, clinical data and symptoms of the Delta variant in pediatric patients are lacking. Aim: To describe clinical characteristics and outcomes of infants admitted in the pediatric intensive care unit (PICU) during the period of Delta variant predominance. Methods: We performed a retrospective study, between June 23, 2021 and August 16, 2021. We included children aged under 15 years, admitted to PICU with severe and critical form of SARS-CoV-2 infection as confirmed by RT-PCR. We reviewed medical records for all patients. Results: During the study period, 20 infants were included. The median age was 47 days (IQR: 26.5–77). The sex ratio was 0.8 (9 males). No underlying medical conditions were noted. Parents were not vaccinated. Respiratory involvement was the main feature to be observed in our cohort. Eleven patients had pediatric acute respiratory distress (PARDS) with a median oxygen saturation index (OSI) of 9 (IQR: 7–11). PARDS was mild in 4 cases, moderate in 5 cases and severe in 2 cases. Hemodynamic instability was observed in 4 cases. The main radiological finding was ground glass opacities in 11 cases. Seventeen patients were mechanically ventilated and 3 of them were escalated to high-frequency oscillatory ventilation. The median duration of mechanical ventilation was 6 days (IQR 2.5–12.5). The remaining patients were managed with high flow nasal cannula. Four patients died. Conclusion: We report herein a case series of very young infants, with no comorbidities, and with a life-threatening illness due to SARS-CoV-2 Delta variant.

Published
2023
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2. Retrospective Analysis of Clinical Characteristics and Disease Outcomes in Children and Adolescents Hospitalized Due to COVID-19 Infection in Tunisia

Author

Aida Borgi, Khaoula Meftah, Ines Trabelsi, Moe H. Kyaw, Hela Zaghden, Aida Bouafsoun, Fatma Mezghani, Nada Missaoui, Alya Abdel Ali, Leila Essaddam, Haifa Khemiri, Sondes Haddad-Boubaker, Khedija Boussetta, Monia Khemiri, Saida Ben Becher, Samir Boukthir, Henda Triki, Khaled Menif, and Hanen Smaoui

Subjects
observational study, COVID-19, pediatric population, clinical characteristics, disease severity, comorbidities, Microbiology, QR1-502
Abstract

Due to low susceptibility of coronavirus disease of 2019 (COVID-19) in children, limited studies are available regarding COVID-19 in the pediatric population in Tunisia. The current study evaluated the incidence, clinical characteristics, and outcomes of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection among children hospitalized at Béchir Hamza Children’s Hospital. A retrospective cohort analysis was conducted using the hospital database between March 2020 and February 2022 with children aged ≤15 years with SARS-CoV-2 infection (confirmed by RT-PCR). A total of 327 COVID-19 hospitalized patients with a mean age of 3.3 years were included; the majority were male. Neurological disease (20%) was the most common comorbidity, while fever (95.3%) followed by cough (43.7%) and dyspnea (39.6%) were the most frequent symptoms reported. Severe disease with oxygen requirement occurred in 30% of the patients; 13% were admitted in the Intensive Care Unit. The overall incidence rate of COVID-19 hospitalization (in Tunis governorates) was 77.02 per 100,000 while the inpatient case fatality rate was 5% in the study population. The most prevalent circulating variant during our study period was Delta (48.8%), followed by Omicron (26%). More than 45% of the study population were n = 25, 26.5%) had at least one comorbidity. Thus, the study findings highlight the high disease burden of COVID-19 in infants.

Published
2024
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3. Severe and critical SARS‐COV‐2 delta variant infection in infants without underlying medical conditions

Author

Aida Borgi, Assaad Louati, Amal Miraoui, Lilia Lahmar, Khaoula Mefteh, Ahmed Hajji, Ahmed Ayari, Asma Bouziri, Khaled Menif, Hanen Smaoui, and Nejla Benjaballah

Subjects
acute respiratory distress syndrome, intensive care, mechanical ventilation, SARS‐CoV‐2, Diseases of the respiratory system, RC705-779
Abstract

Abstract We report herein a case series of infants, with no comorbidities, who developed a life‐threatening illness due to the SARS‐CoV‐2 Delta variant. We retrospectively reviewed the medical records of children, aged under 15 years, admitted to PICU, during the peak of Delta infection, between June 23 and August 16 2021, with severe and critical forms of SARS‐CoV‐2 infection, confirmed by RT‐PCR. Twenty infants were included, the median age was 47 days (IQR: 26.5–77) and sex ratio was 0.8. No underlying medical conditions were noted. Parents were not vaccinated. Respiratory involvement was the main feature observed. Eleven patients had paediatric acute respiratory distress (PARDS) with a median oxygen saturation index (OSI) of 9 (IQR: 7–11). PARDS was mild in four, moderate in five, and severe in two cases. Hemodynamic instability was observed in 4 cases. The main radiological finding was ground glass opacities in 11 cases. Seventeen patients were mechanically ventilated, and three of them were escalated to high‐frequency oscillatory ventilation. The median duration of mechanical ventilation was 6 days (IQR 2.5–12.5). The remaining patients were managed with high‐flow nasal cannula. Four patients died.

Published
2022
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4. First Tunisian cluster admissions of critically ill patients with multisystem inflammatory syndrome in children (MIS-C)

Author

aida borgi

Subjects
Diseases of the blood and blood-forming organs, RC633-647.5
Abstract

Background: Multisystem inflammatory syndrome in children (MIS-C) is a new serious emerging disease that is temporally related to previous exposure to coronavirus infection disease (COVID-19). Aim: To describe the clinical features, laboratory findings, therapies and outcomes for the first Tunisian cluster admissions of critically ill children with severe MIS-C. Methods: Retrospective study conducted between 01 November and 30 November 2020 We included 8 children aged less than 15 years who were admitted to our pediatric intensive care and met the criteria for MIS-C according to the WHO definition case. We reviewed the medical records of all patients to collect demographic and clinical data, severity scores, laboratory test results, echocardiographic findings, treatment, and outcomes. Results: All children were previously fit and well. Seven patients were boys. Known exposure to COVID-19 was reported in 4 cases. Fever and gastrointestinal symptoms were reported in all cases. Five patients had marked abdominal pain and were examined by the surgeon for a possible appendicitis. Seven patients had diarrhea. On examination, we found a rash (n=7), a conjunctivitis (n=7), a cheilitis (n=5) and a meningism (n=3). We reported cardiac dysfunction in 7 cases and a shock with hypotension in 3 cases. All patients received immunoglobulins, methyl prednisolone and a low dose of aspirine. No deaths occurred. Conclusion: We reported here the first Tunisian cluster admissions of 8 critically ill children with MIS-C to highlight the increase of a new severe emerging disease with an evidence of prior COVID-19 infection in older children.

Published
2021
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5. PREDICTORS OF MORTALITY IN MECHANICALLY VENTILATED CRITICAL PERTUSSIS IN A LOW INCOME COUNTRY: NEW RESURGENCE IN 2013.

Author

Aida Borgi

Subjects
critical pertussis, ventilation, predictors of mortality, Diseases of the blood and blood-forming organs, RC633-647.5
Abstract

Background: Critical pertussis is characterized by severe respiratory failure, severe leukocytosis, pulmonary hypertension, septic shock and encephalopathy. Aim: To describe the clinical course of critical pertussis and identify predictors of death at the time of presentation for medical care. Methodology: retrospective study conducted in children’s hospital Tunisian PICU between 01 January and 31 october 2013. Patients with critical pertussis confirmed by RT-PCR and requiring mechanical ventilation were included. Predictors of death were studied. Results : A total of 17 patients were included. Median age was 50 days. Mortality was 23%. Predictors risk of mortality were high PRISM (p=0,007), shock (p=0,002), tachycardia (p=0,005), seizures (p=0,006), altered mental status(p=0,006), elevated WBC count (p=0,003) and hemodynamic support (p=0022). However difference did not reach statistical significance in comorbidity, pneumoniae, high pulmonary hypertension or exchange transfusion. Concomitant viral or bacterial coinfection wasn’t related to poor outcome. Conclusion: Young infants are at high risk to have critical pertussis. Despite advances in life support and the treatment of organ failure in childhood critical illness, critical pertussis remains difficult to treat.

Published
2014
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6. Congenital Thrombotic Thrombocytopenic Purpura: Atypical Presentation And First ADAMTS 13 Mutation In A Tunisian Child

Author

aida borgi

Subjects
thrombotic thrombocytopenic purpura, Upshaw-Schulman syndrome, ADAMTS 13, plasmatherapy., Diseases of the blood and blood-forming organs, RC633-647.5
Abstract

Background: Congenital deficiency of ADAMTS13 is characterized by systemic platelet clumping, hemolytic anemia and multiorgan failure. Although, more than 100 mutations have been reported, atypical clinical presentation may be involved in diagnostic difficulties. Case report: A 2 year old Tunisian child presented with chronic thrombopenic purpura which failed to respond to corticosteroids. Hemolytic anemia with schizocytes, occurred ten months later, with no previous history of diarrhea or any neurological abnormality. Renal function, coagulation screening tests and complement assay were normal. The count of platelet improved after fresh frozen infusion (FFP). Extensive investigations revealed a severe deficiency of ADAMTS 13 activity (level< 5%). Gene sequencing identified mutation in exon 18 of ADAMTS 13 gene. Prophylactic regimen with regular infusions of FFP was associated to favorable outcome. Conclusion: Early ADAMTS 13 activity testing and gene sequencing associated to precocious plasmatherapy are crucial to reduce morbidity and mortality of congenital TTP.

Published
2013
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7. Study on Hemolytic Uremic Syndrome Complicating Invasive Streptococcus pneumoniae Infections: Tunisian Experience

Author

Yousra, Hammi, primary, Taha, Sayari, additional, Haifa, Chaffai, additional, Aida, Borgi, additional, Manel, Jallouli, additional, Kamel, Abidi, additional, Asma, Bouziri, additional, Ammar, Khaldi, additional, Yousr, Gorgi, additional, Taieb, Ben Abdallah, additional, Najla, Ben Jaballah, additional, and Tahar, Gargah, additional

Published
2021
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8. Proceedings of Réanimation 2017, the French Intensive Care Society International Congress

Author

Bougouin, Wulfran, Marijon, Eloi, Planquette, Benjamin, Karam, Nicole, Dumas, Florence, Celermajer, David, Jost, Daniel, Lamhaut, Lionel, Beganton, Frankie, Cariou, Alain, Meyer, Guy, Jouven, Xavier, Bureau, Côme, Charpentier, Julien, Salem, Omar Ben Hadj, Guillemet, Lucie, Arnaout, Michel, Ferre, Alexis, Geri, Guillaume, Mongardon, Nicolas, Pène, Frédéric, Chiche, Jean-Daniel, Mira, Jean-Paul, Labro, Guylaine, Belon, François, Luu, Vinh-Phuc, Chenet, Julien, Besch, Guillaume, Puyraveau, Marc, Piton, Gaël, Capellier, Gilles, Martin, Maëlle, Lascarrou, Jean-Baptiste, Le Thuaut, Aurélie, Lacherade, Jean-Claude, Martin-Lefèvre, Laurent, Fiancette, Maud, Vinatier, Isabelle, Lebert, Christine, Bachoumas, Konstantinos, Yehia, Aihem, Henry-Laguarrigue, Matthieu, Colin, Gwenhaël, Reignier, Jean, Privat, Elodie, Escutnaire, Joséphine, Dumont, Cyrielle, Baert, Valentine, Vilhelm, Christian, Hubert, Hervé, Robert-Edan, Vincent, Lakhal, Karim, Quartin, Andrew, Hobbs, Brian, Cely, Cynthia, Bell, Cynthia, Pham, Tai, Schein, Roland, Geng, Yimin, Ng, Chaan, Ehrmann, Stephan, Gandonnière, Charlotte Salmon, Boisramé-Helms, Julie, Le Tilly, Olivier, De Bretagne, Isabelle Benz, Mercier, Emmanuelle, Mankikian, Julie, Bretagnol, Anne, Meziani, Ferhat, Halimi, Jean Michel, Le Guellec, Chantal Barin, Gaudry, Stéphane, Hajage, David, Tubach, Florence, Pons, Bertrand, Boulet, Eric, Boyer, Alexandre, Chevrel, Guillaume, Lerolle, Nicolas, Carpentier, Dorothée, de Prost, Nicolas, Lautrette, Alexandre, Mayaux, Julien, Nseir, Saad, Ricard, Jean-Damien, Dreyfuss, Didier, Robert, René, Garzotto, Franscesco, Kipnis, Eric, Tetta, Ciro, Ronco, Claudio, Schnell, David, Aurelie, Bourmaud, Reynaud, Marie, Clec’h, Christophe, Benyamina, Mourad, Vincent, François, Mariat, Christophe, Bornstain, Caroline, Rouleau, Stephane, Leroy, Christophe, Cohen, Yves, Morel, Jerome, Legrand, Matthieu, Terreaux, Jeremy, Darmon, Michaël, Cantier, Marie, Morisot, Adeline, Guérot, Emmanuel, Canet, Emmanuel, De Montmollin, Etienne, Voiriot, Guillaume, Neuville, Mathilde, Timsit, Jean-François, Sonneville, Romain, Fayssoil, Abdallah, Stojkovic, Tania, Behin, Anthony, Ogna, Adam, Lofaso, Frédéric, Laforet, Pascal, Wahbi, Karim, Prigent, Helene, Duboc, Denis, Orlikowski, David, Eymard, Bruno, Annane, Djillali, Le Guennec, Loic, Cholet, Clémentine, Bréchot, Nicolas, Hekimian, Guillaume, Besset, Sébastien, Lebreton, Guillaume, Nieszkowska, Ania, Trouillet, Jean Louis, Leprince, Pascal, Combes, Alain, Luyt, Charles-Edouard, Griton, Marion, Sesay, Musa, De Panthou, Nadia Sibaï, Bienvenu, Thomas, Biais, Matthieu, Nouette-Gaulain, Karine, Fossat, Guillaume, Baudin, Florian, Coulanges, Cécile, Bobet, Sabrine, Dupont, Arnaud, Courtes, Léa, Benzekri, Dalila, Kamel, Toufik, Muller, Grégoire, Bercault, Nicolas, Barbier, François, Runge, Isabelle, Skarzynski, Marie, Mathonnet, Armelle, Boulain, Thierry, Jouan, Youenn, Teixera, Noémie, Hassen-Khodja, Claire, Guillon, Antoine, Gaborit, Christophe, Grammatico-Guillon, Leslie, Rebière, Cécile, Azoulay, Elie, Misset, Benoit, Ruckly, Stephane, Garrouste-Orgeas, Maïté, Kentish-Barnes, Nancy, Duranteau, Jacques, Thuong, Marie, Joseph, Liliane, Renault, Anne, Lesieur, Olivier, Larbi, Anne-Gaelle Si, Viquesnel, Gérald, Zuber, Benjamin, Marque, Sophie, Kandelman, Stanislas, Pichon, Nicolas, Floccard, Bernard, Galon, Marion, Chevret, Sylvie, Kentish-Barnes, Nancy, Seegers, Valérie, Legriel, Stéphane, Jaber, Samir, Lefrant, Jean Yves, Reuter, Danielle, Guisset, Olivier, Cracco, Christophe, Seguin, Amélie, Durand-Gasselin, Jacques, Thirion, Marine, Cohen-Solal, Zoé, Foulgoc, Hélène, Rogier, Julien, Delobbe, Elsa, Schortgen, Frédérique, Asfar, Pierre, Julie, Boisramé-Helms, Grimaldi, David, Fabien, Grelon, Anguel, Nadia, Sigismond, Lasocki, Matthieu, Henry-Lagarrigue, Gonzalez, Frédéric, François, Legay, Guitton, Christophe, Schenck, Maleka, Jean-Marc, Doise, Radermacher, Peter, Kentish-Barnes, Nancy, Makunza, Joseph Nsiala, Nathalie, Mejeni Kamdem, Pierre, Akilimali, Adolphe, Kilembe Manzanza, Mahieu, Rafael, Reydel, Thomas, Jamet, Angéline, Chudeau, Nicolas, Huntzinger, Julien, Grange, Steven, Courte, Anne, Lemarie, Jérémie, Gibot, Sébastien, Champey, Julia, Dellamonica, Jean, Du Cheyron, Damien, Contou, Damien, Tadié, Jean-Marc, Cour, Martin, Beduneau, Gaetan, Marchalot, Antoine, Guérin, Laurent, Jochmans, Sebastien, Terzi, Nicolas, Preau, Sebastien, Brun-Buisson, Christian, Dessap, Armand Mekontso, Vedrenne-Cloquet, Meryl, Breinig, Sophie, Jung, Camille, Brussieux, Maxime, Marcoux, Marie-Odile, Durrmeyer, Xavier, Blondé, Renaud, Angoulvant, François, Grasset, Jérôme, Naudin, Jérôme, Dauger, Stéphane, Remy, Solenn, Kolev-Descamp, Karine, Demaret, Julie, Monneret, Guillaume, Javouhey, Etienne, Chomton, Maryline, Sauthier, Michaël, Vallieres, Emilie, Jouvet, Philippe, Geslain, Guillaume, Guellec, Isabelle, Rambaud, Jérôme, Schmidt, Matthieu, Schellongowski, Peter, Dorget, Amandine, Patroniti, Nicolo, Taccone, Fabio Silvio, Miranda, Dinis Reis, Reuter, Jean, Prodanovic, Hélène, Pierrot, Marc, Balik, Martin, Park, Sunghoon, Guérin, Claude, Papazian, Laurent, Jean, Reignier, Ayzac, Louis, Loundou, Anderson, Forel, Jean-Marie, Mezidi, Mehdi, Aublanc, Mylène, Perinel-Ragey, Sophie, Lissonde, Floriane, Louf-Durier, Aurore, Tapponnier, Romain, Yonis, Hodane, Coudroy, Remi, Frat, Jean-Pierre, Boissier, Florence, Thille, Arnaud W., Richard, Flore, Le Gullou-Guillemette, Hélène, Fahri, Jonathan, Kouatchet, Achille, Bodet-Contentin, Laetitia, Garot, Denis, Le Pennec, Déborah, Vecellio, Laurent, Tavernier, Elsa, Dequin, Pierre François, Messika, Jonathan, Martin, Yolaine, Maquigneau, Natacha, Puechberty, Christelle, Stoclin, Annabelle, Villard, Serge, Dechanet, Aline, De Jong, Audrey, Monnin, Marion, Girard, Mehdi, Chanques, Gérald, Molinari, Nicolas, Decavèle, Maxens, Campion, Sébastien, Ainsouya, Roukia, Niérat, Marie-Cécile, Raux, Mathieu, Similowski, Thomas, Demoule, Alexandre, Razazi, Keyvan, Tchir, Martial, May, Faten, Carteaux, Guillaume, Pauline, Rougevin-Baville, Marc, Andronikof, Bedos, Jean Pierre, Mehrsa, Koukabi, Mauger-Briche, Carole, Mijon, François, Trouiller, Pierre, Sztrymf, Benjamin, Cretallaz, Pierre, Mermillod-Blondin, Romain, Savary, Dominique, Sedghiani, Ines, Doghri, Hamdi, Jendoubi, Asma, Hamdi, Dhekra, Cherif, Mohamed Ali, Hechmi, Youssef Zied El, Zouheir, Jerbi, Persico, Nicolas, Maltese, Francois, Ferrigno, Cécile, Bablon, Amandine, Marmillot, Cécile, Roch, Antoine, Sedghiani, Ines, Papin, Grégory, Gainnier, Marc, Argaud, Laurent, Christophe, Adrie, Souweine, Bertrand, Goldgran-Toledano, Dany, Marcotte, Guillaume, Dumenil, Anne Sylvie, Carole, Schwebel, Cecchini, Jerôme, Tuffet, Samuel, Fartoukh, Muriel, Roux, Damien, Thyrault, Martial, Armand, Mekontso Dessap, Chauveau, Simon, Wesner, Nadège, Monnier-Cholley, Laurence, Bigé, Naïke, Ait-Oufella, Hafid, Guidet, Bertrand, Dubée, Vincent, Labroca, Pierre, Lemarié, Jérémie, Chiesa, Gérard, Laroyenne, Isabelle, Borrini, Léo, Klotz, Rémi, Sy, Quoc Phan, Cristina, Marie-Christine, Paysant, Jean, Fillâtre, Pierre, Gacouin, Arnaud, Revest, Matthieu, Tattevin, Pierre, Flecher, Erwan, Le Tulzo, Yves, Jamme, Matthieu, Daviaud, Fabrice, Marin, Nathalie, Thy, Michael, Duceau, Baptiste, Ardisson, Fanny, Sandrine, Valade, Venot, Marion, Schlemmer, Benoît, Zafrani, Lara, Pons, Stéphanie, Styfalova, Lenka, Bouadma, Lila, Radjou, Aguila, Lebut, Jordane, Mourvillier, Bruno, Dorent, Richard, Dilly, Marie-Pierre, Nataf, Patrick, Wolff, Michel, Le Gall, Aëlle, Bourcier, Simon, Tandjaoui-Lambiotte, Yacine, Das, Vincent, Alves, Mikael, Bigé, Naïke, Kamilia, Chtara, Rania, Ammar, Baccouch, Najeh, Turki, Olfa, Ben, Hmida Chokri, Bahloul, Mabrouk, Bouaziz, Mounir, Dupuis, Claire, Perozziello, Anne, Letheulle, Julien, Valette, Marc, Herrmann-Storck, Cécile, Crosby, Laura, Elkoun, Khalid, Madeux, Benjamin, Martino, Frédéric, Migueres, Hélène, Piednoir, Pascale, Posch, Matthias, Thiery, Guillaume, Huynh-Ky, Minh-Tu, Bouchard, Pierre Alexandre, Sarrazin, Jean-François, Lellouche, François, Nay, Mai-Anh, Lortat-Jacob, Brice, Rozec, Bertrand, Colnot, Marion, Belin, Nicolas, Barrot, Loïc, Navellou, Jean-Christophe, Patry, Cyrille, Chaignat, Claire, Claveau, Melanie, Claude, Frédéric, Aubron, Cécile, Mcquilten, Zoe, Bailey, Michael, Board, Jasmin, Buhr, Heidi, Cartwright, Bruce, Dennis, Mark, Forrest, Paul, Hodgson, Carol, Mcilroy, David, Murphy, Deirdre, Murray, Lynnette, Pellegrino, Vincent, Pilcher, David, Sheldrake, Jayne, Tran, Huyen, Vallance, Shirley, Cooper, Jamie, Bombled, Camille, Vidal, Charles, Margetis, Dimitri, Amour, Julien, Coart, Domien, Dubois, Jasperina, Van Herpe, Tom, Mesotten, Dieter, Bailly, Sébastien, Lucet, Jc, Lepape, Alain, L’hériteau, François, Aupée, Martine, Bervas, Caroline, Boussat, Sandrine, Berger-Carbonne, Anne, Machut, Anaïs, Savey, Anne, Tudesq, Jean-Jacques, Valade, Sandrine, Galicier, Lionel, De Bazelaire, Cédric, Munoz-Bongrand, Nicolas, Mignard, Xavier, Biard, Lucie, Mokart, Djamel, Nyunga, Martine, Bruneel, Fabrice, Rabbat, Antoine, Perez, Pierre, Meert, Anne Pascale, Benoit, Dominique, Mariotte, Eric, Ehooman, Franck, Hamidfar-Roy, Rebecca, Hourmant, Yannick, Mailloux, Arnaud, Beurton, Alexandra, Teboul, Jean-Louis, Girroto, Valentina, Laura, Galarza, Richard, Christian, Monnet, Xavier, Dubée, Vincent, Merdji, Hamid, Dang, Julien, Preda, Gabriel, Baudel, Jean-Luc, Desnos, Cyrielle, Zeitouni, Michel, Belaroussi, Ines, Parrot, Antoine, Blayau, Clarisse, Fulgencio, Jean-Pierre, Quesnel, Christophe, Labbe, Vincent, De Chambrun, Marc Pineton, Beloncle, François, Merceron, Sybille, Fedun, Yannick, Lecomte, Bernard, Devaquet, Jérôme, Puidupin, Marc, Verdière, Bruno, Amoura, Zahir, Vuillard, Constance, Xavier, Jais, Bourlier, Delphine, David, Amar, Caroline, Sattler, David, Montani, Gerald, Simmoneau, Olivier, Sitbon, Humbert, Marc, Laurent, Savale, Dujardin, Olivier, Bouglé, Adrien, Ait, Hamou Nora, Salem, Joe Elie, El-Helali, Najoua, Coppere, Zoé, Gibelin, Aude, Taconet, Clementine, Djibre, Michel, Maamar, Adel, Colobert, Elen, Fillatre, Pierre, Uhel, Fabrice, Camus, Christophe, Moraly, Josquin, Dahoumane, Redouane, Maury, Eric, Tan, Boun Kim, Emmanuel, Vivier, Pauline, Misslin, Laurence, Parmeland, Philippe, Poirié, Zahar, Jean-Ralph, Catherine, Haond, Christian, Pommier, Karim, Ait-Bouziad, Mounia, Hocine, Laura, Témime, Rasoldier, Vero Hanitra, Mager, Guy, Eraldi, Jean-Pierre, Gelinotte, Stéphanie, Bougerol, François, Dehay, Julien, Rigaud, Jean-Philippe, Declercq, Pierre Louis, Michel, Julien, Aissa, Nejla, Henard, Sandrine, Guerci, Philippe, Latar, Ichraq, Levy, Bruno, Girerd, Nicolas, Kimmoun, Antoine, Abdallah, Saousen Ben, Nakaa, Sabrine, Hraiech, Kmar, Braiek, Dhouha Ben, Adhieb, Ali, M’ghirbi, Abdelwaheb, Ousji, Ali, Hammouda, Zeineb, Abroug, Fekri, Sellami, Walid, Hajjej, Zied, Samoud, Walid, Labbene, Iheb, Ferjani, Mustapha, Medhioub, Fatma Kaaniche, Allela, Rania, Algia, Najla Ben, Cherif, Samar, Attia, Delphine, Herinjatovo, Andrianjafy, Francois, Xavier Laborne, Bouhouri, Med Aziz, Slaoui, Mohamed Taoufik, Soufi, A., Khaleq, K., Hamoudi, D., Nsiri, A., Harrar, R., Maury, Eric, Goursaud, Suzanne, Gauberti, Maxime, Labeyrie, Paul-Emile, Gaberel, Thomas, Agin, Véronique, Maubert, Eric, Vivien, Denis, Gakuba, Clément, Armel, Anwar, Abdou, Rchi, Kalouch, Samira, Yaqini, Khalid, Chlilek, Aziz, Sellami, Walid, Yedder, Soumaya Ben, Tonnelier, Alexandre, Hervé, Fabien, Halley, Guillaume, Frances, Jean-Luc, Moriconi, Mickael, Saoli, Mathieu, Garnero, Aude, Demory, Didier, Arnal, Jean Michel, Canoville, Bertrand, Daubin, Cédric, Brunet, Jennifer, Ghezala, Hassen Ben, Snouda, Salah, Ben, Chiekh Imen, Kaddour, Moez, Ouanes, Islem, Marzouk, Mahdi, Haniez, Françoise, Jaillet, Hélène, Maas, Henri, Andrivet, Pierre, Darné, Christian, Viau, François, Ghezala, Hassen Ben, Ouanes, Islem, Dangers, Laurence, Montlahuc, Claire, Perbet, Sébastien, Ouanes, Islem, Hamouda, Zeineb, Nakee, Sabrine, Ouanes-Besbes, Lamia, Meddeb, Khaoula, Khedher, Ahmed, Sma, Nesrine, Ayachi, Jihene, Khelfa, Messaouda, Fraj, Nesrine, Lakhal, Hend Ben, Hammed, Hedia, Boukadida, Raja, Hafsa, Hajer, Chouchene, Imed, Boussarsar, Mohamed, Ben, Braiek Dhouha, Ouanes-Besbes, Lamia, Benatti, Kaoutar, Dafir, A., Aissaoui, W., Elallame, W., Haddad, W., Cherkab, R., Elkettani, C., Barrou, L., Hamou, Zakaria Ait, Repessé, Xavier, Charron, Cyril, Aubry, Alix, Paternot, Alexis, Maizel, Julien, Slama, Michel, Vieillard-Baron, Antoine, Trifi, Ahlem, Abdellatif, Sami, Fatnassi, Meriem, Daly, Foued, Nasri, Rochdi, Ismail, Khaoula Ben, Lakhal, Salah Ben, Bazalgette, Florian, Daurat, Aurelien, Roger, Claire, Muller, Laurent, Doyen, Denis, Plattier, Rémi, Robert, Alexandre, Hyvernat, Hervé, Bernardin, Gilles, Jozwiak, Mathieu, Gimenez, Julia, Mercado, Pablo, Depret, François, Tilouch, Najla, Mater, Houda, Habiba, Ben Sik Ali, Jaoued, Oussama, Gharbi, Rim, Hassen, Mohamed Fekih, Elatrous, Souheil, Pasquier, Pierre, Vuillemin, Quentin, Schaal, Jean-Vivien, Martinez, Thibault, Duron, Sandrine, Trousselard, Marion, Schwartzbrod, Pierre-Eric, Baugnon, Thomas, Dupic, Laurent, Gout, Caroline Duracher, De Saint Blanquat, Laure, Séguret, Sylvie, Le Ficher, Gaelle, Orliaguet, Gilles, Hubert, Philippe, Bigé, Naïke, Leblanc, Guillaume, Briand, Raphael, Brousse, Lucas, Brunet, Valentine, Chatelain, Léonard, Prat, Dominique, Jacobs, Frédéric, Demars, Nadège, Hamzaoui, Olfa, Moneger, Guy, Sztrymf, Benjamin, Duburcq-Gury, Emilie, Satre-Buisson, Léa, Duburcq, Thibault, Poissy, Julien, Robriquet, Laurent, Jourdain, Merce, Sécheresse, Thierry, Miquet, Mattéo, Simond, Alexis, Usseglio, Pascal, Hamdaoui, Yamina, Boussarsar, Mohamed, Desailly, Victoire, Brun, Patrick, Iglesias, Pauline, Huet, Jérémie, Masseran, Clémence, Claudon, Antoine, Ebeyer, Clément, Truong, Thomas, Tesnière, Antoine, Mignon, Alexandre, Gaudry, Stéphane, Resiere, Dabor, Valentino, Ruddy, Fabre, Julien, Roze, Benoit, Ferge, Jean-Louis, Charbatier, Cyrille, Marie, Sabia, Scholsser, Michel, Aitsatou, Signate, Raad, Mathieu, Cabie, Andre, Mehdaoui, Hossein, Cousin, Clement, Rousseau, Christophe, Llitjos, Jean-François, Alby-Laurent, Fanny, Toubiana, Julie, Belaidouni, Nadia, Cherruault, Marlène, Tamburini, Jérome, Bouscary, Didier, Fert, Sarah, Delile, Eugénie, Besnier, Emmanuel, Coquerel, David, Nevière, Rémi, Richard, Vincent, Tamion, Fabienne, Wei, Chaojie, Louis, Huguette, Margaux, Schmitt, Eliane, Albuisson, Sophie, Orlowski, Kimmoun, Antoine, Riad, Zakaria, Coroir, Marine, Rémy, Bernard, Camille, Bombled, Joffre, Jeremie, Aegerter, Philippe, Ilic, Dejan, Ginet, Marc, Pignard, Caroline, Nguyen, Philippe, Mourey, Guillaume, Samain, Emmanuel, Pili-Floury, Sebastien, Jouffroy, Romain, Nicolas, Caill, Alvarez, Jean-Claude, Tomasso, Maraffi, Philippe, Pascal, Raphalen, Jean-Herlé, Frédéric, J. Baud, Vivien, Benoit, Pierre, Carli, Baud, Frederic, Fredj, Hana, Blel, Youssef, Brahmi, Nozha, Ghezala, Hassen Ben, Hanak, Anne-Sophie, Malissin, Isabelle, Poupon, Joel, Risede, Patricia, Chevillard, Lucie, Megarbane, Bruno, Barghouth, Manel, M’rad, Aymen, Hmida, Marwa Ben, Thabet, Hafedh, Liang, Hao, Callebert, Jacques, Lagard, Camille, Megarbane, Bruno, Habacha, Sahar, Chatbri, Bassem, Camillerapp, Christophe, Labat, Laurence, Soichot, Marion, Garçon, Pierre, Goury, Antoine, Kerdjana, Lamia, Voicu, Sebastian, Deye, Nicolas, Megarbane, Bruno, Armel, Anwar, Anas, Benqqa, Othman, Mezgui, Moumine, S., Kalouch, S., Yakini, K. K., Chlilek, A., Hajji, Ahmed, Louati, Assaad, Khaldi, Ammar, Borgi, Aida, Ghali, Nargess, Bouziri, Asma, Menif, Khaled, Ben, Jaballah Najla, Armel, Anwar, Brochon, Jeanne, Dumitrescu, Mihaela, Thévenot, Sarah, Saulnier, Jean-Pascal, Husseini, Khaled, Laland, Catherine, Cremniter, Julie, Bousseau, Anne, Castel, Olivier, Brémaud-Csizmadia, Cassandra, Diss, Margot, Portefaix, Aurélie, Berthiller, Julien, Gillet, Yves, Aoul, Nabil Tabet, Douah, Ali, Addou, Zakaria, Youbi, Houari, Moussati, Mohamed, Belhabiche, Kamel, Mir, Souad, Abada, Sanaa, Amel, Zerhouni, Aouffen, Nabil, Bouzit, Zina, Grati, Ahmed H., Dhonneur, Gilles F., Boussarsar, Mohamed, Lau, Nicolas, Mezhari, Ilham, Roucaud, Nicolas, Le Meur, Matthieu, Paulet, Rémi, Coudray, Jean-Michel, Ghomari, Wahiba Imène, Boumlik, Reda, Peigne, Vincent, Daban, Jean-Louis, Boutonnet, Mathieu, Lenoir, Bernard, Yassine, Hafiani, Mohamed, Cheikh Chaigar, Khalid, Allali, Ihssan, Moussaid, Said, Elyoussoufi, Said, Salmi, Jazia, Amira Ben, Fatima, Jaziri, Wafa, Skouri, Maha, Bennasr, Khaoula, Ben Abdelghni, Sami, Turki, Abdallah Taeib, B., Medhioub, Fatma Kaaniche, Rollet-Cohen, Virginie, Sachs, Philippe, Merchaoui, Zied, Renolleau, Sylvain, Oualha, Mehdi, Eloi, Maxime, Jean, Sandrine, Demoulin, Maryne, Valentin, Cécile, Guilbert, Julia, Walti, Hervé, Carbajal, Ricardo, Leger, Pierre-Louis, Karaca-Altintas, Yasemin, Botte, Astrid, Labreuche, Julien, Drumez, Elodie, Devos, Patrick, Bour, Franck, Leclerc, Francis, Ahmed, Ayari, khaled, Menif, Louati, Assaad, Aida, Borgi, Ammar, Khaldi, Narjess, Ghali, Ahmed, Hajji, Asma, Bouziri, Jaballah, Nejla Ben, Leger, Pierre-Louis, Pansiot, Julien, Besson, Valérie, Palmier, Bruno, Baud, Olivier, Cauli, Bruno, Charriaut-Marlangue, Christiane, Mansuy, Amélie, Michel, Fabrice, Le Bel, Stéphane, Boubnova, Julia, Ughetto, Fabrice, Ovaert, Caroline, Fouilloux, Virginie, Paut, Olivier, Jacquet-Lagrèze, Matthias, Tiebergien, Nicolas, Hanna, Najib, Evain, Jean-Noël, Baudin, Florent, Courtil-Teyssedre, Sonia, Bompard, Dominique, Lilot, Marc, Chardonal, Laurent, Fellahi, Jean-Luc, Claverie, Claire, Pouessel, Guillaume, Dorkenoo, Aimée, Renaudin, Jean-Marie, Eb, Mireille, Deschildre, Antoine, Leteurtre, Stéphane, Yassine, Hafiani, Kamal, Belkadi, Adil, Oboukhlik, Ouafa, Aalalam, Mouhamed, Moussaoui, Rachid, Charkab, Lahoucine, Barrou, Dachraoui, Fahmi, Nakkaa, Sabrine, Zaineb, Hammouda, Mlika, Dorra, Gloulou, Olfa, Boussarsar, Mohamed, Zelmat, Setti-Aouicha, Batouche, Djamila-Djahida, Chaffi, Belkacem, Mazour, Fatima, Benatta, Nadia, Fathallah, Ines, Aloui, Rafaa, Zoubli, Aymen, Kouraichi, Nadia, Fathallah, Ines, Kouraichi, N., Salem, Shireen, Vicaut, Eric, Megarbane, Bruno, Ambroise, David, Loriot, Anne-Marie, Bourgogne, Emmanuel, Megarbane, Bruno, Ghadhoune, Hatem, Jihene, Guissouma, Trabelsi, Insaf, Allouche, Hend, Brahmi, Habib, Samet, Mohamed, Ghord, Hatem El, Lebeau, Rodolphe, Laplanche, Jean-Louis, Benturquia, Nadia, Megarbane, Bruno, Blel, Youssef, M’rad, A., Essafi, Fatma, Benabderrahim, A., Jouffroy, Romain, Resiere, Dabor, Sanchez, Bruno, Inamo, Jocelyn, Megarbane, Bruno, Batouche, Djamila-Djahida, Zerhouni, Amel, Tabeliouna, Kheira, Negadi, Amine, Mentouri, Zahia, Le Gall, Fanny, Hanouz, Jean-Luc, Normand, Hervé, Khoury, Abdo, Sall, Fatimata Seydou, De Luca, Alban, Pugin, Aurore, Pazart, Lionel, Vidal, Chrystelle, Leroux, Franck, Khoury, Abdo, L’Her, Erwan, Marjanovic, Nicolas, Khoury, Abdo, Desmettre, Thibault, Lambert, Christophe, Ragey, Sophie Perinel, Baboi, Loredana, Bazin, Jean-Etienne, Koffel, Catherine, Dhonneur, Gilles, Bouzit, Zina, Bradai, Larbi, Ayed, Issam Ben, Aissa, Fethi, Haouache, Hakim, Marechal, Yoann, Biston, Patrick, Piagnerelli, Michael, Bortolotti, Perrine, Colling, Delphine, Colas, Vincent, Voisin, Benoit, Dewavrin, Florent, Onimus, Thierry, Girardie, Patrick, Saulnier, Fabienne, Urbina, Tomas, Nguyen, Yann, Druoton, Anne-Lise, Soudant, Marc, Barraud, Damien, Conrad, Marie, Cravoisy-Popovic, Aurélie, Nace, Lionel, Bollaert, Pierre-Edouard, Martin, Ruste, Bitker, Laurent, Richard, Jean-Christophe, Brossier, David, Goyer, Isabelle, Marquis, Christopher, Lampin, Marie, Duhamel, Alain, Béhal, Hélène, Dhaoui, Tahar, Godeffroy, Véronique, Devouge, Eve, Evrard, Dominique, Delepoulle, Florence, Racoussot, Sylvie, Grandbastien, Bruno, Lampin, Marie, Heilbronner, Claire, Roy, Emeline, Masson, Alexandra, Hadchouel-Duvergé, Alice, Rigourd, Virginie, Delacroix, Elise, Wroblewski, Isabelle, Pin, Isabelle, Ego, Anne, Payen, Valerie, Debillon, Thierry, Millet, Anne, Denot, Julien, Berthelot, Véronique, Thueux, Emilie, Reymond, Marie, De Larrard, Alexandra, Amblard, Alain, Leger, Pierre-Louis, Aoul, Nabil Tabet, Lemiale, Virginie, Oziel, Johanna, Brule, Noelle, Moreau, Anne-Sophie, Marhbène, Takoua, Sellami, Salma, Jamoussi, Amira, Ayed, Samia, Mhiri, Emna, Slim, Leila, Khelil, Jalila Ben, Besbes, Mohamed, Chawki, Sylvain, Hamdi, Aicha, Ciroldi, Magali, Cottereau, Alice, Obadia, Edouard, Zerbib, Yoann, Andrejak, Claire, Ricome, Sylvie, Dupont, Hervé, Baudin, François, Dureau, Pauline, Tanguy, Audrey, Arbelot, Charlotte, Ben, Hassen Kais, Charfeddine, Ahmed, Granger, Benjamin, Laporte, Lucile, Hermetet, Coralie, Regaieg, Kais, Khemakhem, Rim, Chelly, Hedi, Cheikh, Chaigar Mohammed, Mountij, Hamid, Rghioui, Kawtar, Haddad, Wafae, Cherkab, Rachid, Barrou, Houcine, Naima, Aitmouden, bennani, Othmani M., Regaieg, Kais, Douib, Ahmed, Samet, Amal, Cungi, Pierre-Julien, Nguyen, Cédric, Cotte, Jean, D’aranda, Erwan, Meaudre, Eric, Avaro, Jean-Phillipe, Slaoui, Mohamed Taoufik, Mokline, Amel, Rahmani, Imene, Laajili, Achraf, Amri, Helmi, Gharsallah, Lazheri, Gasri, Bahija, Tlaili, Sofiene, Hammouda, Rym, Messadi, Amen Allah, Sudden Death Expertise Center, AKIKI Study Group, DO-RE-MI-FA Group, ENCEPHALITICA Study Group, for the HYPER2S Investigators and REVA Research Network, for the Purpura Fulminans Study Group, GFRUP RMEF, REVA ECMOnet, REA-RAISIN Study Group, for the EurêClark Study Group, and Groupe Communication et Simulation en Pédiatrie

Published
2017
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10. High flow nasal cannula therapy versus continuous positive airway pressure and nasal positive pressure ventilation in infants with severe bronchiolitis: a randomized controlled trial

Author

Aida Borgi, Mohamed Hssairi, Ahmed Ayari, Assaad Louati, Khaled Menif, Narjess Ghali, Asma Bouziri, Nejla Benjaballah, and Ahmed Hajji

Subjects
Adult, Adolescent, medicine.medical_treatment, medicine.disease_cause, nasal cannula, law.invention, Young Adult, pressure, Randomized controlled trial, law, Medicine, Cannula, Humans, Continuous positive airway pressure, Positive pressure ventilation, Child, Bronchiolitis, continuous positive airway, Aged, Aged, 80 and over, Continuous Positive Airway Pressure, business.industry, Research, Oxygen Inhalation Therapy, Infant, General Medicine, Middle Aged, medicine.disease, Respiration, Artificial, United States, Anesthesia, business, High flow, Nasal cannula
Abstract

Introduction:non-invasive ventilation is widely used in the respiratory management of severe bronchiolitis. Methods:a randomized controlled trial was carried out in a tertiary pediatric university hospital´s PICU over 3 years to compare between continuous positive airway pressure/nasal positive pressure ventilation (CPAP/NPPV) and high flow nasal cannula (HFNC) devices for severe bronchiolitis. The trial was recorded in the national library of medicine registry (NCT04650230). Patients aged from 7 days to 6 months, admitted for severe bronchiolitis were enrolled. Eligible patients were randomly chosen to receive either HFNC or CPAP/NPPV. If HFNC failed, the switch to CPAP/NPPV was allowed. Mechanical ventilation was the last resort in case of CPAP/NPPV device failure. The primary outcome was the success of the treatment defined by no need of care escalation. The secondary outcomes were failure predictors, intubation rate, stay length, serious adverse events, and mortality. Results:a total of 268 patients were enrolled. The data of 255 participants were analyzed. The mean age was 51.13 ± 34.43 days. Participants were randomized into two groups; HFNC group (n=130) and CPAP/NPPV group (n=125). The success of the treatment was significantly higher in the CPAP/NPPV group (70.4% [61.6%- 78.2%) comparing to HFNC group (50.7% [41.9%- 59.6%])- (p=0.001). For secondary outcomes, lower baseline pH was the only significant failure predictor in the CPAP/NPPV group (p=0.035). There were no differences in intubation rate or serious adverse events between the groups. Conclusion:high flow nasal cannula was safe and efficient, but CPAP/ NPPV was better in preventing treatment failure. The switch to CPAP/NPPV if HFNC failed, avoided intubation in 54% of the cases.

Published
2021

12. First Tunisian cluster admissions of critically ill patients with multisystem inflammatory syndrome in children (MIS-C)

Author

Assaad Louati, Aida Borgi, Nejla Ben Jaballah, Hend Khadhraoui, Asma Bouziri, Ahmed Ayari, Khaled Menif, and Ahmed Hajji

Subjects
Pediatrics, medicine.medical_specialty, Abdominal pain, business.industry, Medical record, Meningism, Retrospective cohort study, Hematology, medicine.disease, Disease cluster, Rash, Appendicitis, Infectious Diseases, Intensive care, medicine, medicine.symptom, business
Abstract

Background: Multisystem inflammatory syndrome in children (MIS-C) is a new serious emerging disease that is temporally related to previous exposure to coronavirus infection disease (COVID-19). Aim: To describe the clinical features, laboratory findings, therapies and outcomes for the first Tunisian cluster admissions of critically ill children with severe MIS-C. Methods: Retrospective study conducted between 01 November and 30 November 2020 We included 8 children aged less than 15 years who were admitted to our pediatric intensive care and met the criteria for MIS-C according to the WHO definition case. We reviewed the medical records of all patients to collect demographic and clinical data, severity scores, laboratory test results, echocardiographic findings, treatment, and outcomes. Results: All children were previously fit and well. Seven patients were boys. Known exposure to COVID-19 was reported in 4 cases. Fever and gastrointestinal symptoms were reported in all cases. Five patients had marked abdominal pain and were examined by the surgeon for a possible appendicitis. Seven patients had diarrhea. On examination, we found a rash (n=7), a conjunctivitis (n=7), a cheilitis (n=5) and a meningism (n=3). We reported cardiac dysfunction in 7 cases and a shock with hypotension in 3 cases. All patients received immunoglobulins, methyl prednisolone and a low dose of aspirine. No deaths occurred. Conclusion: We reported here the first Tunisian cluster admissions of 8 critically ill children with MIS-C to highlight the increase of a new severe emerging disease with an evidence of prior COVID-19 infection in older children.

Published
2021

13. Influenza A/H1N1 pdm 09 in children's Hospital Bechir Hamza of Tunis

Author

Faten, Tinsa, Hajer, Barakizou, Imen, Belhadj, Zohra, Fitouri, Aida, Borgi, Azza, Samoud, Saida, Ben Becher, Najla, Ben Jabbalah, Olfa, Bouyahia, and Khadija, Boussetta

Subjects
Male, Tunisia, Fever, Infant, Bacterial Infections, Length of Stay, Hospitals, Pediatric, Polymerase Chain Reaction, Dyspnea, Influenza A Virus, H1N1 Subtype, Child, Preschool, Influenza, Human, Humans, Female, Child, Pandemics, Retrospective Studies
Abstract

Influenza A (H1N1) is a contagious acute respiratory infection caused a pandemic in 2009. The outcome was variable among populations.To describe a clinical spectrum and the outcome of Tunisian children with pandemic H1N1/09 influenza virus.This is a retrospective, descriptive study of children with pandemic H1N1/09 influenza virus hospitalized in the children's hospital of tunis, between November 2009 and February 2010. The diagnosis was made on positive rapid test or PCR.thirty two children were included. The median age was 12 months. The most frequently symptoms were: fever (87,5%), digestive disorders ( 59,4%) and dyspnea (15,6%). The mean length of stay was 3,8 days. The outcome was complicated by a bacterial infection (56,3%), and one death.Mild form of H1N1/influenza virus is the most common presentation; however severe forms can be observed especially in infants.

Published
2018

14. Community Acquired Methicillin-Resistant Staphylococcus Aureus Preseptal Cellulitis Complicated By Zygomatic Osteomylitis, Cavernous Sinus Thrombosis and Meningitis in a Healthy Child

Author

Aida Borgi, Asma Bouziri, Lilia Ben Hassine, Nejla Ben Jaballah, Khaled Menif, and Ammar Khaldi

Subjects
Methicillin-Resistant Staphylococcus aureus, medicine.medical_specialty, Cavernous sinus thrombosis, medicine.disease_cause, Pathology and Forensic Medicine, medicine, Humans, Meningitis, Zygoma, business.industry, Osteomyelitis, Cavernous Sinus Thrombosis, Infant, Cellulitis, Pneumonia, General Medicine, Staphylococcal Infections, medicine.disease, Methicillin-resistant Staphylococcus aureus, Surgery, Community-Acquired Infections, Venous thrombosis, Staphylococcus aureus, Pediatrics, Perinatology and Child Health, Female, business
Abstract

We report a case of community-acquired meticillin-resistant Staphylococcus aureus (CA-MRSA) preseptal cellulitis complicated by zygomatic osteomyelitis, cavernous sinus thrombosis, meningitis, and necroziting pneumonia in a previously healthy two and half month old girl. This case exemplifies an aggressive and disseminated CA-MRSA infection with deep venous thrombosis in an infant without predisposing risk factors. The literature is reviewed and recommendations for management are provided.

Published
2011

16. Toxic epidermal necrolysis complicated by small bowel intussusception: a case report

Author

Aida Borgi, Ammar Khaldi, Sofiene Ghorbel, Nejla Ben Jaballah, Monia Kharfi, A. Hamdi, Khaled Menif, Sarra Bel Hadj, and Asma Bouziri

Subjects
Male, medicine.medical_specialty, Enteral administration, Ileum, Intussusception (medical disorder), medicine, Humans, Sex organ, Child, Body surface area, Ileal Diseases, business.industry, General Medicine, Abdominal distension, medicine.disease, Toxic epidermal necrolysis, Surgery, Diarrhea, Treatment Outcome, Parenteral nutrition, Stevens-Johnson Syndrome, Pediatrics, Perinatology and Child Health, Parenteral Nutrition, Total, medicine.symptom, business, Intussusception
Abstract

Intestinal involvement in toxic epidermal necrolysis (TEN) has been identified only rarely. We report a case of TEN complicated by small bowel intussusception. The patient was a previously healthy 8-year-old boy who presented with TEN and extensive lesions, including up to 40% of the body surface area as well as conjunctival, oropharyngeal, respiratory, and genital mucosa. Rapidly after the onset of a constant rate of enteral feeding, he developed bilious vomiting, diarrhea, and significant abdominal distension. Abdominal sonography showed a small bowel intussusception. At abdominal exploration, an ileoileal intussusception was observed with a viable but inflamed bowel wall. Manual reduction was performed. During the postoperative clinical course, the patient was managed with total parenteral nutrition and local care of the skin and mucous membranes. Enteral feeding was introduced on the sixth postoperative day, and the child left the hospital 15 days after his admission. The association of TEN and small bowel intussusception has not been previously reported in the literature.

Published
2011

17. Perforated Meckel's diverticulum in a very preterm baby revealed at birth

Author

Najla Benjeballah, Nedia Boujelbene, Serra Belhadj, Asma Bouziri, Nedia Sghairoun, and Aida Borgi

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Birth weight, Perforation (oil well), Pathology and Forensic Medicine, Diagnosis, Differential, Pneumoperitoneum, Enterocolitis, Necrotizing, Pregnancy, Laparotomy, Diseases in Twins, Medicine, Humans, Abdomen, Acute, Meckel's diverticulum, Respiratory Distress Syndrome, Newborn, Respiratory distress, business.industry, Obstetrics, Infant, Newborn, General Medicine, medicine.disease, Surgery, Meckel Diverticulum, Acute abdomen, Intestinal Perforation, Pediatrics, Perinatology and Child Health, Necrotizing enterocolitis, Female, medicine.symptom, business, Infant, Premature
Abstract

Perforated Meckel's diverticulum (MD) in a preterm baby is very rare. We report a case of a very preterm baby, born at 29-week gestation, with a birth weight of 1400 g, admitted in the third hour of life to our intensive care unit (ICU) for respiratory distress syndrome with abdominal distention. An abdominal radiograph showed a pneumoperitoneum. Laparotomy revealed Meckel's perforation. The baby was discharged healthy at the age of 16 days. MD should be kept in mind as one cause of an acute abdomen in preterm neonates mimicking necrotizing enterocolitis. To our knowledge, our patient is the third reported case described in the literature and the first one revealed at birth.

Published
2013

19. Congenital Thrombotic Thrombocytopenic Purpura: Atypical Presentation And First ADAMTS 13 Mutation In A Tunisian Child

Author

M. Khemiri, A. Veyradier, Aida Borgi, K. Kazdaghli, and S. Barsaoui

Subjects
Hemolytic anemia, medicine.medical_specialty, Pediatrics, ADAMTS 13, plasmatherapy, Thrombotic thrombocytopenic purpura, Case Report, Congenital Thrombotic Thrombocytopenic Purpura, Gastroenterology, Internal medicine, hemic and lymphatic diseases, medicine, Thrombopenic purpura, Upshaw–Schulman syndrome, thrombotic thrombocytopenic purpura, business.industry, Upshaw-Schulman syndrome, lcsh:RC633-647.5, ADAMTS, Hematology, lcsh:Diseases of the blood and blood-forming organs, medicine.disease, ADAMTS13, Diarrhea, Infectious Diseases, medicine.symptom, business
Abstract

Background: Congenital deficiency of ADAMTS13 is characterized by systemic platelet clumping, hemolytic anemia and multiorgan failure. Although, more than 100 mutations have been reported, atypical clinical presentation may be involved in diagnostic difficulties. Case report: A 2 year old Tunisian child presented with chronic thrombopenic purpura which failed to respond to corticosteroids. Hemolytic anemia with schizocytes, occurred ten months later, with no previous history of diarrhea or any neurological abnormality. Renal function, coagulation screening tests and complement assay were normal. The count of platelet improved after fresh frozen infusion (FFP). Extensive investigations revealed a severe deficiency of ADAMTS 13 activity (level< 5%). Gene sequencing identified mutation in exon 18 of ADAMTS 13 gene. Prophylactic regimen with regular infusions of FFP was associated to favorable outcome. Conclusion: Early ADAMTS 13 activity testing and gene sequencing associated to precocious plasmatherapy are crucial to reduce morbidity and mortality of congenital TTP.

Published
2013

20. Pseudotumoral cutaneous aspergillosis in chronic granulomatous disease, report of a pediatric case

Author

Aida Borgi, Monia Kharfi, Samir Boubaker, Sihem Barsaoui, Monia Khemiri, Nadia El Fekih, and Université de Tunis El Manar (UTM)

Subjects
Antifungal Agents, Biopsy, [SDV]Life Sciences [q-bio], chronic granulomatous disease, Aspergillosis, Granulomatous Disease, Chronic, MESH: Biopsy, 0302 clinical medicine, Chronic granulomatous disease, MESH: Granulomatous Disease, Chronic, 030212 general & internal medicine, MESH: Treatment Outcome, MESH: Dermatomycoses, Invasive Pulmonary Aspergillosis, 0303 health sciences, child, medicine.diagnostic_test, Cutaneous aspergillosis, Osteomyelitis, General Medicine, 3. Good health, Treatment Outcome, Child, Preschool, Drainage, Female, medicine.medical_specialty, skin, MESH: Invasive Pulmonary Aspergillosis, [SDV.CAN]Life Sciences [q-bio]/Cancer, Dermatology, MESH: Osteomyelitis, Pathology and Forensic Medicine, MESH: Drainage, 03 medical and health sciences, MESH: Skin, medicine, Dermatomycoses, Humans, Surgical Wound Infection, In patient, MESH: Surgical Wound Infection, MESH: Debridement, invasive aspergillosis, MESH: Humans, 030306 microbiology, business.industry, MESH: Child, Preschool, Invasive pulmonary aspergillosis, medicine.disease, MESH: Antifungal Agents, Debridement, Etiology, business, MESH: Female, [SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology
Abstract

International audience; Invasive aspergillosis is a life-threatening condition in patients with chronic granulomatous disease (CGD). Skin invasion by Aspergillus occurs most commonly by contiguity to a neighboring cavity. We describe an unusual case of invasive cutaneous aspergillosis presented as a large burgeoning tumor in a 4-year-old girl with CGD who underwent surgical treatment for bifocal osteomyelitis of the left leg. The skin invasion occurred 4 months after a "successful" treatment of invasive pulmonary aspergillosis. Atypical presentation and diagnostic difficulties are discussed. Invasive cutaneous aspergillosis may be polymorphic. The diagnosis should be considered early in the etiological investigation of any suspicious skin lesions in CGD even in uncommon aspects such as burgeoning tumors.

Published
2012

21. Community-acquired methicillin-resistant Staphylococcus aureus infections requiring admission to a Tunisian pediatric intensive care unit

Author

Khaled, Menif, Asma, Bouziri, Ammar, Khaldi, Asma, Hamdi, Sarra, Belhadj, Aida, Borgi, and Najla, Ben Jaballah

Subjects
Community-Acquired Infections, Methicillin-Resistant Staphylococcus aureus, Tunisia, Child, Preschool, Infant, Newborn, Pneumonia, Bacterial, Humans, Infant, Length of Stay, Staphylococcal Infections, Intensive Care Units, Pediatric, Retrospective Studies
Abstract

There is limited literature describing severe community acquired methicillin-resistant S aureus (CA-MRSA) in children admitted to an intensive care unit.To review clinical features and outcome of children admitted in a Tunisian pediatric intensive care with CA-MRSA.Retrospective chart review of patients coded for CAMRSA over 10 years.There were 14 (0.32% of all admissions) patients identified with severe CA-MRSA. The median age was 3 months (range,0.5-156 months). All patients had pulmonary involvement. Six children (42.8%) developed septic shock. Two (14.3%) patients had multifocal infection with deep venous thrombosis. Two (14.3%) patients died.Severe CA-MRSA pneumonia dominated presentation. The mortality of CA-MRSA infection in our series is lower than reported in the literature.

Published
2011

22. [Early neonatal infection caused by Streptococcus pneumonias: report of 3 cases]

Author

Asma, Bouziri, Sarra, Bel Hadj, Ammar, Khaldi, Aida, Borgi, Khaled, Menif, and Nejla, Ben Jaballah

Subjects
Adult, Male, Pregnancy, Infant, Newborn, Humans, Female, Infectious Disease Transmission, Vertical, Pneumococcal Infections
Abstract

S pneumoniae is a rare cause (1-8 %) of maternofetal infection causing an important morbi-mortality in the newborn and the mother.To report 3 cases of early neonatal infection due to S pneumonia.Three cases of early neonatal infection due to S pneumoniae are reported. The three newborns were at term or near term babies with a vaginal delivery in two cases and a caesarean section in one case. They presented severe symptoms, with a progressive onset after birth, leading to hypoxemic pneumonia in one case and to septic shock in two newborns associated with meningitis in one case. S pneumoniae was isolated in the blood culture in two patients with positive soluble antigens in the cerebrospinal fluid in one case and positive peripheral bacteriological swabs in the other case. In the third case, S pneumoniae was isolated in the tracheal sample of the newborn and his mother. S pneumoniae was sensitive to ampicillin in two patients and of decreased sensitivity to ampicillin in one patient. The clinical course was favourable in the three patients after hospitalization in the intensive care unit.Early neonatal infections caused by S pneumonia are rare and are an important cause of morbi-mortality in the newborn and the mother.

Published
2011

23. Multifocal atrial tachycardia: an unusual cause of cardiogenic shock in a newborn

Author

Asma, Bouziri, Ammar, Khaldi, Asma, Hamdi, Ines, Ben Massoud, Aida, Borgi, Khaled, Menif, and Nejla, Ben Jaballah

Subjects
Male, Tachycardia, Ectopic Atrial, Respiratory Distress Syndrome, Newborn, Infant, Newborn, Shock, Cardiogenic, Humans
Abstract

Chaotic or multifocal atrial tachycardia (MAT) is a rare tachyarrhythmia in children, accounting for less than 1% of supraventricular tachycardia seen in childhood. The majority of children with MAT are healthy; a few may exhibit mild to life threatening cardiorespiratory disease.To report a new case of MAT revealed by a severe respiratory distress and cardiogenic shock.We report a rare case of MAT revealed by a severe respiratory distress and cardiogenic shock in a 12-day-old newborn. The echocardiogram demonstrated an isolated secundum-type atrial septal defect with a decreased left ventricular function. He was successfully treated with intravenous amiodarone. A relay by oral amiodarone and digoxine was made. Four months later, he had no recurrence of arrhythmia and left ventricular function returned to normal.Our case is original by its association to an isolated ostium secondum-type atrial septal defect and by the occurrence of a congestive heart failure revealing the arrhythmia and the structural heart disease during the neonatal period.

Published
2011

24. Community-associated methicillin-resistant Staphylococcus aureus infections in a pediatric intensive care unit

Author

Ammar Khaldi, Aida Borgi, Khaled Menif, Zahra Fitouri, Najla Ben Jaballah, S. Belhadj, A. Hamdi, and Asma Bouziri

Subjects
Lung Diseases, Male, Methicillin-Resistant Staphylococcus aureus, Pediatrics, medicine.medical_specialty, Tunisia, Adolescent, medicine.disease_cause, Intensive Care Units, Pediatric, Microbiology, Severity of Illness Index, Community associated, Virology, Chart review, medicine, Humans, Child, Developing Countries, Pediatric intensive care unit, business.industry, Septic shock, Infant, General Medicine, biochemical phenomena, metabolism, and nutrition, Staphylococcal Infections, bacterial infections and mycoses, medicine.disease, Methicillin-resistant Staphylococcus aureus, Community-Acquired Infections, Venous thrombosis, Pneumonia, Infectious Diseases, Staphylococcus aureus, Child, Preschool, Parasitology, Female, business
Abstract

Introduction: Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infection is an increasing problem worldwide. In developing countries, there is little data on CA-MRSA infection in children. This study reviewed the clinical features and outcomes of children admitted in a Tunisian pediatric intensive care unit with severe CA-MRSA infections. Methodology: Retrospective chart review of patients coded for CA-MRSA over 10 years. Results: There were 14 (0.32% of all admissions) patients identified with severe CA-MRSA infections. The median age was three months (range, 0.5-156 months). All patients had pulmonary involvement. Six children (42.8%) developed septic shock. Two (14.3%) patients had multifocal infection with deep venous thrombosis. Two (14.3%) patients died. Conclusions: Severe CA-MRSA pneumonia dominated presentation. The mortality of CA-MRSA infection in our series is lower than that previously reported.

Published
2010

26. Rabies encephalitis in a child: a failure of rabies post exposure prophylaxis?

Author

Khadija Boussetta, Aida Borgi, Faten Tinsa, and Imen Jahouat

Subjects
Male, Hypersalivation, Pediatrics, medicine.medical_specialty, Time Factors, Rabies, medicine.medical_treatment, Acyclovir, Hydrophobia, Antiviral Agents, Article, Dogs, Fatal Outcome, Rabies vaccine, Febrile seizure, medicine, Animals, Humans, Bites and Stings, Dog Diseases, cvg, Post-exposure prophylaxis, Child, Fluorescent Antibody Technique, Indirect, business.industry, cvg.computer_videogame, Immunoglobulins, Intravenous, General Medicine, medicine.disease, Dog bite, Rabies virus, Immunology, Autopsy, medicine.symptom, Post-Exposure Prophylaxis, business, medicine.drug, Rare disease
Abstract

Rabies remains a serious public health problem in many developing countries. The diagnosis is easy when a non-immunised patient presents with hydrophobia and hypersalivation after a bite by a known rabid animal but more difficult when a patient presents atypical symptoms after having received rabies postexposure prophylaxis. Rabies postexposure prophylaxis failure is rare. We report a case of a 6-year-old boy who presented febrile seizure with agitation and cerebellar signs, without hydrophobia or hypersalivation, 17 days after a dog bite. Despite four doses of rabies vaccine and immunoglobulin, he died. Diagnostic confirmation of rabies encephalitis was made in post mortem on brain biopsies by fluorescent antibody technique.

Published
2015

27. PS-213 Epidemiology And Outcome Of Neonatal Septic Shock In A Picu Of Tunisia

Author

A. Hamdi, S. Belhadj, Asma Bouziri, Aida Borgi, N. Ghali, Khaled Menif, M Chamem, Ammar Khaldi, N. Benjaballah, and S Mahdoui

Subjects
Mechanical ventilation, Pediatrics, medicine.medical_specialty, business.industry, Septic shock, medicine.medical_treatment, Mortality rate, Retrospective cohort study, medicine.disease, Pneumonia, Bronchiolitis, Pediatrics, Perinatology and Child Health, Epidemiology, medicine, Bronchitis, business
Abstract

Background Neonatal septic shock is a devastating condition associated with high morbidity and mortality. Methods A retrospective study was conducted in children’s hospital Tunisian PICU between 2005 to 2013. All neonates ( Results A total of 40 neonates were included. Mean age on admission was 34 h±3.7. Mean SNAPP score was 25 ± 17. Materno-fetal infection was observed in 37 cases, staphylococcal pneumonia in 2 cases and bacterial coinfection with bronchiolitis in the last case. The bacteriological study showed a notable predominance of streptococcus B (40%) and E.coli (35%). All patients required mechanical ventilation (mean duration: 85 ± 556 h) and haemodynamic support (mean duration 49 ± 335 h). Mortality rate was 19% in full term infants, 12.5% in near term infants and 27% in extremely preterm infants. Conclusions Our results would indicate a high mortality rate in neonatal septic shock. A goal –directed therapy for septic shock, implanted in our PICU, could improve outcomes for this vulnerable population.

Published
2014

28. PO-0265 Non Invasive Ventilation For Severe Bronchiolitis

Author

Aida Borgi, N. Ghali, Asma Bouziri, A. Hamdi, N Ben Jeballah, Khaled Menif, and S Mahdoui

Subjects
Pediatrics, medicine.medical_specialty, Respiratory rate, business.industry, Apnea, medicine.disease, medicine.disease_cause, Respiratory failure, Bronchiolitis, Anesthesia, Pediatrics, Perinatology and Child Health, Positive airway pressure, Breathing, Medicine, Bronchitis, medicine.symptom, business, Nasal cannula
Abstract

Introduction Non-invasive ventilation (NIV) is a relatively new ventilatory mode that has been increasingly used in the acute setting over the past 15 years, demonstrating beneficial effects in the paediatric population with different types of respiratory failure. Objectives To examine whether infants with severe bronchiolitis could be managed with non-invasive ventilation (NIV) alone. To study the characteristics, clinical course and outcome of NIV patients. Patients and methods A retrospective analysis was made of infants with severe bronchiolitis in a Paediatric Intensive Care Unit admitted from 01/09/2011 to 31/01/2012 and from 01/09/2012 to 31/02/2013. One thousand and sixty-four infants with severe bronchiolitis were admitted. One thousand and two were invasively ventilated, seventy-two were treated with NIV. We aimed to examine the characteristics, clinical course and outcome for those who received NIV. Results Seventy-two patients, including 6 with apnea, were treated exclusively with NIV. The mean age was de 54,2 days ± 39,1 (8–221). The mean respiratory rate was 61 breaths/min ±16,7 (20–104). NIV was delivered by continuous (CPAP) in seven patients, bi-level (BiPAP) positive airway pressure in thirty-four infants and high-flow nasal cannula in thirty-one patients. Twenty-three failed to respond and were invasively ventilated. Risk factors for NIV failure were prematurity and bacterial infection. Duration of hospital stay was shorter in responders. There were no major complications related with NIV. Conclusion This study demonstrates the efficacy of NIV as a form of respiratory support for infants with severe bronchiolitis avoiding ETI in most of the patients. Risk factors for failure were related with immaturity and severe infection.

Published
2014

29. SFIPP P-06 - Etude radiologique des infections graves au virus de la grippe A1(H1N1)/PDM2009

Author

S. Belhadj, Khaled Menif, Asma Bouziri, N. Ghali, N. Benjaballah, Aida Borgi, and Ammar Khaldi

Subjects
Pediatrics, Perinatology and Child Health
Abstract

Objectifs Analyse de la radiographie du thorax a l’admission des patients hospitalises en reanimation pediatrique pour grippe A/H1N1pdm09. Materiels et methodes Etude retrospective, entre novembre 2009 et mars 2010 avec relecture de la radiographie du thorax a l’admission de tous les patients hospitalises pour grippe A/N1N1pdm 09 confirmee par PCR, dans leservice de reanimation pediatrique de l’hopital d’enfants de Tunis et de l’unite de reanimation pediatrique de l’hopital Farhat Hached de Sousse Resultats Nous avons collige 37 patients, d’âge median 5mois et demi. Les differents aspects radiologiques retrouves etaient : un infiltrat alveolaire bilateral diffus dans 15,6% des cas, un infiltrat alveolaire non diffus dans 31,3% des cas, un infiltrat alveolaire unilateral dans 18,7% des cas, un epanchement pleural liquidien dans 1 cas et un pneumothorax dans 1 cas. La radiographie du thorax etait normale dans 28,1% des cas. Conclusion L’aspect radiologique le plus frequemment retrouve chez enfants admis pour infections severes dues aux virus de la grippe A/H1N1pdm09 etait l’infiltrat alveolaire bilateral non diffus.

Published
2014

30. ABSTRACT 396

Author

N. Ben Jaballah, Aida Borgi, Khaled Menif, M. Fares, N. Ghali, Ammar Khaldi, S. Bel Hadj, and Asma Bouziri

Subjects
Pediatric intensive care unit, medicine.medical_specialty, business.industry, Pediatrics, Perinatology and Child Health, medicine, Acute respiratory distress, Critical Care and Intensive Care Medicine, Intensive care medicine, business
Published
2014

31. ABSTRACT 598

Author

Ammar Khaldi, A. Hamdi, N. Benjaballah, N. Ghali, Khaled Menif, S. Belhadj, Asma Bouziri, and Aida Borgi

Subjects
business.industry, Pediatrics, Perinatology and Child Health, Immunology, Medicine, Critical Care and Intensive Care Medicine, business
Published
2014

32. ABSTRACT 394

Author

Aida Borgi, N. Benjaballah, Ammar Khaldi, A. Hamdi, Asma Bouziri, Khaled Menif, N. Ghali, and S. Belhadj

Subjects
business.industry, Anesthesia, Pediatrics, Perinatology and Child Health, Meconium aspiration syndrome, Medicine, Critical Care and Intensive Care Medicine, business, medicine.disease, High frequency oscillatory ventilation, Term (time)
Published
2014

33. Datura stramonium L. poisoning in a geophagous child: a case report

Author

Zohra Fitouri, Aida Borgi, Nejla Ben Jaballah, Asma Bouziri, Khaled Menif, A. Hamdi, and Sarra Bel Hadj

Subjects
Pediatrics, medicine.medical_specialty, Datura stramonium, Unusual case, Young child, Traditional medicine, biology, business.industry, medicine.drug_class, food and beverages, Case Report, biology.organism_classification, Young age, Emergency Medicine, medicine, Accidental ingestion, Anticholinergic, Scopolamine, business, Geophagia, medicine.drug
Abstract

Datura stramonium L. (DS) is a wild-growing plant widely distributed and easily accessible. It contains a variety of toxic anticholinergic alkaloids such as atropine, hyoscamine, and scopolamine. Voluntary or accidental ingestion can produce severe anticholinergic poisoning. We report an unusual case of DS intoxication occurring in a geophagous young child after accidental ingestion of the plant. Our case is original because of the young age of the victim and the underlying geophagia facilitating the occurrence of poisoning.

Published
2011

34. 646 Impact of Ductal Size on Successful Medical Closure of Patent Ductus Arteriosus in Preterm Infants

Author

A. Hamdi, Khaled Menif, Aida Borgi, S. Belhadj, Ammar Khaldi, Asma Bouziri, and N. Ben Jaballah

Subjects
congenital, hereditary, and neonatal diseases and abnormalities, medicine.medical_specialty, medicine.anatomical_structure, business.industry, Ductus arteriosus, embryonic structures, Pediatrics, Perinatology and Child Health, cardiovascular system, Medicine, cardiovascular diseases, Closure (psychology), business, Surgery
Abstract

646 Impact of Ductal Size on Successful Medical Closure of Patent Ductus Arteriosus in Preterm Infants

Published
2010

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