Background
Cardiac and neurological involvement in hemolytic uremic syndrome are life-threatening complications. The most frequent complications of cardiac involvement in hemolytic uremic syndrome are myocarditis and cardiac dysfunction due to fluid overload. Pericarditis remains very rare in hemolytic uremic syndrome. To our knowledge, only five cases of cardiac tamponade associated with hemolytic uremic syndrome have been described in literature.
Case summary
A 27-month-old Caucasian girl presented with symptoms of nonbloody diarrhea and tonic-clonic seizures. The diagnosis of Shiga-like toxin-producing Escherichia coli hemolytic uremic syndrome with central nervous system involvement was made, and stool examination revealed infection with a Shiga-like toxin-producing Escherichia coli. She did not need renal replacement therapy but had severe neurological impairment. The patient’s course was complicated by pericardial effusion. A pericardiocentesis was performed via an apical approach because the pericardial effusion was predominantly surrounding the left ventricle. Effusion analysis showed an exudate and positivity for human herpesvirus-6B on polymerase chain reaction with viremia. This finding was consistent with primary human herpesvirus-6 infection with encephalitis.
Conclusion
We report this uncommon case of Shiga-like toxin-producing Escherichia coli hemolytic uremic syndrome associated with a severe human herpesvirus-6 infection. Secondary isolated pericardial effusion and atypical neurological involvement are uncommon in Shiga-like toxin-producing Escherichia coli hemolytic uremic syndrome and should lead the physician to perform additional investigations.
Le principe de la musicothérapie repose sur une approche holistique via la stimulation des aspects sensoriels, cognitifs, comportementaux et psycho-sociaux de chacun. La musicothérapie agit sur la variation des paramètres physiologiques comme la fréquence cardiaque, la fréquence respiratoire, et la tension artérielle.La musicothérapie via des logiciels spécifiques (séquence en « U ») ou des intervenants formés est de plus en plus utilisée dans les services de réanimation adulte ainsi que les services de réanimation néonatale. Cette revue présente les indications et les effets de la musicothérapie dans ces services (gestion de l’angoisse et de la douleur chez les patients intubés, ventilés ou non, impact sur le sommeil, le développement psychomoteur). L’expérience en réanimation pédiatrique est encore embryonnaire.Une étude pilote en réanimation pédiatrique incluant 21 enfants suggère que la mise en place de la musicothérapie est faisable avec une bonne intégration de cette méthode lors des soins quotidiens tel que la toilette.
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