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Background: Ten months after its appearance in December 2019, SARS-CoV-2 has infected more than 25 million patients worldwide. Because children were first identified as potential spreaders of the virus, schools were closed in several countries. However, it rapidly became evident that the number of hospitalized children infected by SARS-CoV-2 was dramatically lower than that of adults. To date, only hypotheses have been raised to explain this difference, so it is of great importance to describe the presentation of this disease among children. Here, we describe a wide spectrum of COVID-19 manifestation in children in a dedicated pediatric unit in France. Methods: Patients hospitalized with COVID-19 who were diagnosed on the basis of either positive SARS-CoV-2 RT-PCR in nasopharyngeal swabs and/or typical aspects in chest-computed tomography (CT) were included between March and May 2020 in Paris. Results: Twenty-three patients were included on the basis of positive RT-PCR (n = 20) and/or typical aspects in CT (n = 4). The median age was 4.9 years [0.1–17.6]. Patients were grouped by age (<2 years old: n = 14, 61%; 2–10 years old: n = 2, 9%; >10 years old: n = 7, 30%). Overweight or obesity was reported in only three patients. At presentation, the most frequent symptom in the overall cohort was fever (n = 18, 78%), followed by acute rhinitis (n = 9, 64%) and cough (n = 7, 50%) in the under 2-year-old group and cough (n = 4, 57%), fatigue, dyspnea and abdominal pain (n = 3, 43% each) in the over 10-year-old group. Five patients required ICU treatment, four of whom were aged >10 years, two presented with acute myocarditis, and two were sickle cell disease patients who presented with acute chest syndrome. Discussion and conclusion: The youngest patients seem to present milder forms of COVID-19 without the need for ICU treatment and with a shorter length of hospitalization. More severe evolutions were observed in teenagers, with, however, favorable outcomes. Given the context of closed schools and confinement, the infection of these children suggests intra-familial transmission that needs to be further assessed. This description might help to understand the intriguing differences in COVID-19 severity across age-classes.

Background: Small intestinal bacterial overgrowth treatment is usually based on antibiotics with no guidelines available.Objective: This study aimed to investigate the efficacy of different antibiotics to treat small intestinal bacterial overgrowth.Methods: Consecutive patients referred to our tertiary center and diagnosed with intestinal bacterial overgrowth were retrospectively included. Patients were diagnosed using a 75 g glucose breath test. Patients were treated either with a single antibiotic (quinolone or azole) or rotating antibiotics (quinolone and azole, one after the other) for 10 consecutive days per month for 3 months. A negative glucose breath test after antibiotic treatment was considered as remission. Quality of life (GIQLI) and gastrointestinal severity (IBS-SSS) were assessed before and after antibiotic treatment. Symptomatic evaluation was realized in simple blind of glucose breath test result: patients were unaware of their results.Results: Between August 2005 and February 2020, 223 patients were included in the analysis (female 79.8%, mean age 50.2 ± 15.7 years). Remission was observed in 119 patients (53.4%) after one course of antibiotics and was more frequent in patients receiving rotating antibiotics than in patients receiving a single antibiotic (70.0% vs. 50.8%, p = 0.050). Remission was associated with a significant improvement in quality of life (p = 0.035) and in bloating (p = 0.004). Conclusion:In this study, the treatment of small intestinal bacterial overgrowth using rotating antibiotics was more effective than treatment using a single course of antibiotic. Remission was associated with improvement in both quality of life and bloating.

Bone metastases from prostate cancer most commonly affect the axial and proximal appendicular skeleton with rare involvement of the distal limbs. We describe a case of multiple bone metastases confined to the left lower limb in a patient with biochemical recurrence of prostate cancer. Following an initial post-operative PSA rise, the patient received a course of salvage radiotherapy to the pelvis, however, the PSA level continued to rise and two consequent staging CT scans were negative for local recurrence and metastatic disease. Subsequent development of left ankle pain and swelling led the patient to present to his General Practitioner, which triggered a series of imaging investigations that revealed isolated left lower limb bone metastases. This case report highlights the need to consider peripheral limb bone metastases in patients with biochemical recurrence of prostate cancer, particularly in the setting of a negative staging CT scan and/or bone pain.

LINKED CONTENT This article is linked to Volkers et al papers. To view these articles, visit https://doi.org/10.1111/apt.17153 and https://doi.org/10.1111/apt.17407

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So far, Streptococcus devriesei, which belongs to the mutans streptococci group, has been incriminated in the formation of caries in Equidae. We report the first human infection due to this species in a 54-year-old man with gangrenous cholecystitis. The patient was treated successfully by cholecystectomy and ceftriaxone.