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• W2015655604 abstract "Les fièvres prolongées ne sont pas rares en pratique pédiatrique. Elles posent avant tout un problème de diagnostic étiologique compte tenu de la multiplicité des causes. En zone tropicale africaine, l’attention des praticiens se focalise le plus souvent sur les infections bactériennes et le paludisme, ce qui conduit quasi systématiquement à la prescription abusive d’antibiotiques ou d’antipaludiques. La trypanosomose humaine africaine (THA) ou maladie du sommeil, affection parasitaire dont la recrudescence est signalée depuis quelques années dans les régions d’endémie, est une cause possible mais souvent méconnue de fièvre prolongée chez l’enfant. Par ailleurs, avec le développement des transports aériens, des cas d’enfants infectés à l’occasion d’un séjour en Afrique peuvent s’exporter en dehors des zones d’endémie, rendant le diagnostic encore plus problématique. L’étude de trois observations permet de rappeler les signes cliniques et biologiques évocateurs du diagnostic de THA, chez un enfant vivant en zone d’endémie sommeilleuse ou y ayant séjourné au cours des mois précédant la consultation. Le pronostic de la maladie est largement dépendant de la précocité du diagnostic et de la prise en charge thérapeutique. Prolonged fever is an important cause of morbidity in pediatric practice, especially in tropical areas. It is above all a problem of etiological diagnosis given the vast number of etiologies. In sub-Saharan Africa, practitioners more often focus on bacterial infections and malaria at the expense of other infectious diseases such as human African trypanosomiasis (HAT), most often leading to overuse of antibiotics and antimalarials. A dramatic resurgence of HAT, also called sleeping sickness, has been reported during the last few decades in large areas of Central Africa. Furthermore, with the development of air transport, cases of children infected during a trip to Africa can be exported outside endemic areas, making diagnosis even more difficult. This parasitic infection causes a protracted, often initially unrecognized, illness with episodes of fever, headache, and malaise, accompanied by progressive lymphadenopathy, before the development of a progressive meningoencephalitis. These three case reports aim to remind practitioners of clinical and biological signs suggestive of HAT diagnosis in children living in endemic areas or having stayed there during the months prior to visiting the doctor. The prognosis is largely dependent on the precocity of diagnosis and therapeutic support." @default.
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• W2015655604 date "2013-08-01" @default.
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• W2015655604 title "Trypanosomose humaine africaine révélée par une fièvre prolongée : à propos de trois cas pédiatriques" @default.
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• W2015655604 doi "https://doi.org/10.1016/j.arcped.2013.05.018" @default.
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