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2. Pandemic A/H1N1v influenza 2009 in hospitalized children: a multicenter Belgian survey

Author

Blumental Sophie, Huisman Elisabeth, Cornet Marie-Coralie, Ferreiro Christine, De Schutter Iris, Reynders Marijke, Wybo Ingrid, Kabamba-Mukadi Benoît, Armano Ruth, Hermans Dominique, Nassogne Marie-Cécile, Mahadeb Bhavna, Fonteyne Christine, Van Berlaer Gerlant, Levy Jack, Moulin Didier, Vergison Anne, Malfroot Anne, and Lepage Philippe

Subjects
Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background During the 2009 influenza A/H1N1v pandemic, children were identified as a specific "at risk" group. We conducted a multicentric study to describe pattern of influenza A/H1N1v infection among hospitalized children in Brussels, Belgium. Methods From July 1, 2009, to January 31, 2010, we collected epidemiological and clinical data of all proven (positive H1N1v PCR) and probable (positive influenza A antigen or culture) pediatric cases of influenza A/H1N1v infections, hospitalized in four tertiary centers. Results During the epidemic period, an excess of 18% of pediatric outpatients and emergency department visits was registered. 215 children were hospitalized with proven/probable influenza A/H1N1v infection. Median age was 31 months. 47% had ≥ 1 comorbid conditions. Febrile respiratory illness was the most common presentation. 36% presented with initial gastrointestinal symptoms and 10% with neurological manifestations. 34% had pneumonia. Only 24% of the patients received oseltamivir but 57% received antibiotics. 10% of children were admitted to PICU, seven of whom with ARDS. Case fatality-rate was 5/215 (2%), concerning only children suffering from chronic neurological disorders. Children over 2 years of age showed a higher propensity to be admitted to PICU (16% vs 1%, p = 0.002) and a higher mortality rate (4% vs 0%, p = 0.06). Infants less than 3 months old showed a milder course of infection, with few respiratory and neurological complications. Conclusion Although influenza A/H1N1v infections were generally self-limited, pediatric burden of disease was significant. Compared to other countries experiencing different health care systems, our Belgian cohort was younger and received less frequently antiviral therapy; disease course and mortality were however similar.

Published
2011
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4. Sildenafil therapy for neonatal and childhood pulmonary hypertensive vascular disease.

Author

UCL - (SLuc) Service de pédiatrie générale, Humpl, Tilman, Reyes, Janette T, Erickson, Simon, Armano, Ruth, Holtby, Helen, Adatia, Ian, UCL - (SLuc) Service de pédiatrie générale, Humpl, Tilman, Reyes, Janette T, Erickson, Simon, Armano, Ruth, Holtby, Helen, and Adatia, Ian

Abstract

In children under 5 years of age with severe pulmonary hypertension, sildenafil therapy resulted in prolonged hemodynamic improvements without adverse effects. Sildenafil attenuated rebound pulmonary hypertension after withdrawal of inhaled nitric oxide.

Published
2011

5. Pandemic A/H1N1v influenza 2009 in hospitalized children: a multicenter Belgian survey.

Author

Blumental, Sophie, Huisman, Elisabeth, Cornet, Marie-Coralie, Ferreiro, Christine, De Schutter, Iris, Reynders, Marijke, Wybo, Ingrid, Kabamba, B., Armano, Ruth, Hermans, Dominique, Nassogne, Marie-Cécile, Mahadeb, Bhavna, Fonteyne, Christine, Van Berlaer, Gerlant, Levy, Jack, Moulin, Didier, Vergison, Anne, Malfroot, Anne, Lepage, Philippe, Blumental, Sophie, Huisman, Elisabeth, Cornet, Marie-Coralie, Ferreiro, Christine, De Schutter, Iris, Reynders, Marijke, Wybo, Ingrid, Kabamba, B., Armano, Ruth, Hermans, Dominique, Nassogne, Marie-Cécile, Mahadeb, Bhavna, Fonteyne, Christine, Van Berlaer, Gerlant, Levy, Jack, Moulin, Didier, Vergison, Anne, Malfroot, Anne, and Lepage, Philippe

Abstract

During the 2009 influenza A/H1N1v pandemic, children were identified as a specific "at risk" group. We conducted a multicentric study to describe pattern of influenza A/H1N1v infection among hospitalized children in Brussels, Belgium., Journal Article, SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2011

6. Meningitis with subdural empyema due to non-typhoid Salmonella in a 9-month-old girl

Author

UCL - MD/NOPS - Département de neurologie et de psychiatrie, UCL - MD/GYPE - Département de gynécologie, d'obstétrique et de pédiatrie, UCL - (SLuc) Service de neurologie pédiatrique, UCL - MD/RAIM - Département de radiologie et d'imagerie médicale, UCL - (SLuc) Service de pédiatrie générale, UCL - (SLuc) Service de radiologie, UCL - (SLuc) Service de médecine interne générale, Ghais, Ahmad, Armano, Ruth, Menten, Renaud, Mathot, Mikaël, Zech, Francis, Nassogne, Marie-Cécile, UCL - MD/NOPS - Département de neurologie et de psychiatrie, UCL - MD/GYPE - Département de gynécologie, d'obstétrique et de pédiatrie, UCL - (SLuc) Service de neurologie pédiatrique, UCL - MD/RAIM - Département de radiologie et d'imagerie médicale, UCL - (SLuc) Service de pédiatrie générale, UCL - (SLuc) Service de radiologie, UCL - (SLuc) Service de médecine interne générale, Ghais, Ahmad, Armano, Ruth, Menten, Renaud, Mathot, Mikaël, Zech, Francis, and Nassogne, Marie-Cécile

Abstract

We report a case of a 9-month-old baby admitted to the hospital because of low-grade fever, focal seizures in a context of watery diarrhea for 14 days' duration. The patient workup revealed a mild neutrophilic pleocytosis on cerebrospinal fluid (46 cells/mul), a positive stool culture for Salmonella pomona sensitive to ceftriaxone and ciprofloxacin, and a subdural empyema (SDE) on the cerebral MRI. The child received an intravenous third-generation cephalosporin for 4 weeks which resulted in cure. This case highlights an unusual extra-intestinal complication of non-typhoid salmonella infection. Involvement of the central nervous system with non-typhoidal salmonellosis is an important complication that can result in significant morbidity if not recognized and treated promptly. A focal intra-cranial infection must be considered in the differential diagnosis of any child presenting with focal seizures and gastroenteritis due to Salmonella. Appropriate diagnostic imaging of the head (cerebral CT scan with contrast and/or MRI) is mandatory to exclude the presence of an intra-cranial complication, even in the presence of negative CSF culture for Salmonella. Subfrontal and subtemporal SDE are sometimes missed on axial CT scans and better appreciated on MRI. Non-surgical treatment of small subdural empyemas with prolonged intravenous antibiotic therapy is a therapeutic option.

Published
2009

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