Children with FSs encounter a minor risk of mortality and morbidity. While recurrent seizures are observed in these children, only a minority of these patients develop epilepsy.

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Dear Editor, The hemophagocytic syndrome (HS) is characterized by activation and uncontrolled non-malignant proliferation of T lymphocytes and macrophages leading to cytokine overproduction. Visceral leishmaniasis (VL) is a systemic disease caused by the Leishmania donovani (LD) complex. The association of HS and VL is rarely found in adults and may cause a diagnostic difficulty because of their similarities. We review all reported cases of VL associated with HS by searching PubMed publications till July 2011.We describe a 58-year-old man who was admitted with a 3-week history of fever (40°C), chills, and sweats. The physical examination revealed hepatosplenomegaly without lymphadenopathy. Laboratory tests showed a normocytic normochromic anemia (hemoglobin 6.8 g/dL), white blood cell (WBC) count 2,400 cells/mm 3 (neutrophils, 48%), and platelet count 36×10 9 /L. Serum triglycerides were increased to 378 mg/dL and ferritin was higher than 2,000 ng/mL. Initially, the patient was treated with cefotaxime and ciprofloxacin. Thoracoabdominal computed tomography revealed hepatosplenomegaly, moderate ascites, and bilateral pleural effusions. Fever persisted and imipenem, amikacin, and teicoplanin were started. Bone marrow aspiration (BMA) revealed hypercellularity and macrocytosis with no evidence of malignancy or other infiltrative process. Vitamin B 12 was then given without any reticulocyte response. A second BMA showed an increased number of macrophages with hemophagocytosis. Exhaustive etiological investigations were negative. Antibodies against Leishmania were positive and the two BMA reviewed revealed LD bodies. Amphotericin B desoxycholate was administered as 15 alternate-day infusions of 0.75 mg/kg over 30 days and prednisone 40 mg per day during 30 days. Treatment was well tolerated. Symptoms and clinical findings improved gradually. After 15 days of treatment, laboratory testing disclosed hemoglobin 8.5 g/dL with normal WBC and platelet counts. One month later, anti-Leishmania serology became negative with a normal BMA. No relapse was seen after 12 months.Our search yielded 13 cases of VL associated with HS (Table 1) [1][2][3][4][5][6][7][8][9][10][11][12]. The first BMA often succeed to establish the presence of LD bodies in 70%. Serology for Leishmania was contributive in three negative BMA cases. Amphotericin B desoxycholate was prescribed in four cases. Four patients died.HS is classified into primary and secondary HS which may be associated with rheumatic diseases, malignancy, medication, or infection such as Leishmania spp. The confirmation of HS is established when five out of the eight criteria of HLH are met [13].VL is caused by the protozoan parasites LD and Leishmania infantum and transmitted through the bite of infected female phlebotomine sandflies. The parasite is then

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Les accidents domestiques représentent un problème sérieux de santé publique en pédiatrie. Ils sont responsables d’une lourde morbidité et mortalité parmi la population pédiatrique. Nous avons mené une étude rétrospective colligeant 231 cas d’accidents domestiques chez l’enfant au Service de Pédiatrie de l’Hôpital Hédi Chaker de Sfax durant une période de 5 ans (2008 - 2012). Durant la période d’étude, nous avons colligé 231 cas d’accidents domestiques. Il s’agissait de 124 garçons (53,7%) et 107 filles (46,3%). L’âge moyen était de 2 ans avec des extrêmes de 1 jour et 14 ans. Les enfants âgés de moins de 4 ans étaient les plus exposés (88,7%). Les intoxications accidentelles étaient les accidents les plus fréquents (105 cas). Les caustiques étaient les agents toxiques les plus fréquents (33 cas), suivis par les médicaments (28 cas) puis les hydrocarbures (16 cas). Les accidents par corps étrangers ont représenté le deuxième mécanisme accidentel (64 cas). Il s’agissait de 43 cas d’inhalation de corps étrangers et 21 cas d’ingestion de corps étranger. Nous avons enregistré 28 cas de traumatismes; il s’agissait d’une chute d’une certaine hauteur dans 25 cas. Nous avons recensé 26 cas d’envenimations scorpioniques, 5 noyades, 2 cas de brulure et un seul cas d’électrisation. Les intoxications accidentelles et les accidents par corps étrangers représentent les principaux accidents domestiques dans notre série et la tranche d’âge entre 1 et 4 ans est la plus exposée aux accidents domestiques.

Introduction Pulmonary toxicity causally related to Imatinib (IM) therapy is uncommon in patients with chronic myeloid leukemia. Case report A 61-year-old patient with chronic myeloid leukemia was treated with IM at 400 mg daily dose. One month within IM, he developed skin lesions and then acute dyspnea and non-productive cough. Chest radiograph and high-resolution lung computed tomography (CT) revealed bilateral reticulonodular infiltration in both lungs. According to Naranjo's algorithm, the causality relationship with the drug is probable with a score of 7. The pharmacovigilance investigation was carried out and implicated IM Management & outcome: IM was discontinued and started steroid therapy (Prednisolone®) at 1 mg/kg daily. Two weeks after, the dyspnea, and abnormal X-ray and CT findings are improved. Discussion The early diagnosis of pulmonary toxicity related to IM therapy is needed to avoid further determinal effects of the drug.

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