Bacillus Calmette-Guérin (BCG) vaccine is a widely used vaccine. Management of local BCG complications differs between clinicians, and the optimal approach remains unclear.We aim to describe the epidemiological, clinical and therapeutic aspects of the BCG vaccine side effects in Sfax.This was a retrospective study of all the cases of BCG vaccine adverse reactions recorded in the Dermatology and Paediatrics Departments of Hedi Chaker University Hospital of Sfax over a period of 10 years (2005-2015).Twenty cases of BCG adverse reactions were notified during the study period. Actually, 80% of the patients presented local adverse reactions. The outcome was good in all the followed patients. The rate of disseminated BCG disease was 20%. Biological tests of immunity showed a primary immunodeficiency in three cases, whereas the outcome was fatal in two cases.BCG vaccine adverse reactions range from mild to severe. However, the management of benign local reactions remains unclear. Disseminated BCG disease must alert clinicians to the possibility of a primary immunodeficiency.
The term multiple drug intolerance syndrome is used for patients who express adverse drug reactions to three or more drugs without a known immunological mechanism. It is a distinct clinical entity, different from cross-reactivity. The symptoms can range from a benign rash to life threatening syndromes like drug reaction with eosinophilia and systemic symptoms.We report the case of an 8-year-old child with primary ciliary dyskinesia complicated by bronchiectasis who presented multiple drug intolerance syndrome.Through this observation; we discuss the diagnostic elements of this syndrome.In the absence of validated criteria for diagnosing multiple drug intolerance syndrome, a detailed history is essential, especially to identify the warning signs and the risk factors.
Introduction: Chronic renal failure (CRF) for children is a major problem of public health both in poor and developed countries. This study aimed to investigate the diagnosis and the management options of CRF for children. Patients and methods: This study retrospectively evaluated patients who had Chronic Kidney Disease in the department of pediatric emergency and reanimation in Hedi Chaker hospital in Sfax between 2005 and 2016. Results: Over 11 year’s period, we diagnosed and managed 41 children with CRF. The estimated incidence of CRF is 4.7 new cases per million-child population per year. Parental consanguinity was found in 16 patients (39%). Family history with kidney disease was noted in 6 cases (14.6%). Malformations of the urinary tract were observed in 24 patients (58.5%). Other causes are divided into hereditary kidney disease in 8 patients (19.5%) predominated by primary hyperoxaluria, in vascular nephropathy who were objectified in 5 patients (12%) whereas glomerulopathy were represented in 3 cases (7.5%). No etiology was found in 1 patient. Over the 11 years 22 patients (54%) had renal replacement therapy (RRT). Peritoneal dialysis (PD) was practiced in over then 90% of patients. A passage from peritoneal dialysis to hemodialysis was done in 8 patients. Only four patients had a kidney transplant. The rate of overall mortality in our series was 40% with median of follow-up in 54 months. Conclusion: In Tunisia and in all Low source country children with CRF must be treated by pediatric nephrologists and the pediatric renal transplantation must be developed.
