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Enteric fever among children: 50 cases in a French tertiary care centre.
Background: Enteric fever in France is primarily travel-associated. Characteristics of paediatric cases are scarce and information from field studies in endemic countries might not be generalizable to non-endemic countries. Methods: In this retrospective study, we reviewed all cases of typhoid and paratyphoid fever treated in a French paediatric tertiary care centre from 1993 through 2015. Results: Fifty cases of enteric fever due to Salmonella enterica serovar Typhi (n = 44) and Paratyphi (n = 6) were identified. Sixty-one percent of the children had travelled to Africa and 34 % to the Indian subcontinent. Among travel-associated cases, eighty-five percent were visiting friends and relatives (VFR). Ninety-six percent had high fever associated with gastrointestinal symptoms. Anaemia (66%), elevated CRP (80%), transaminitis (87%) and mild hyponatremia (50%) were the main biological findings. Blood cultures were positive in 90% of cases. Twelve strains (24%) were resistant at least to one antibiotic, and all of them had been isolated since 2003, increasing the resistance rate during this last period to 43% (12/28). Ceftriaxone was administered to 71 patients for a median duration of 6 days (IQR: 4‒8). The median time to apyrexia after onset of treatment was 4 days (IQR: 2‒5 days). Complications occurred in 9 children with 5 (10%) presenting neurologic disorders. All 50 patients recovered. Conclusion: In France, paediatric enteric fever is mainly a travel-associated disease and occurs in patients returning from a prolonged stay in an endemic area. Children VFR are at high risk and should be a priority target group for pre-travel preventive measures. The increase in antibiotic resistance reflects the situation in endemic countries and is a major concern
Revision of Tympanopleura Eigenmann (Siluriformes: Auchenipteridae) with description of two new species
The Neotropical catfish genus Tympanopleura, previously synonymized within Ageneiosus, is revalidated and included species are reviewed. Six species are recognized, two of which are described as new. Tympanopleura is distinguished from Ageneiosus by having an enlarged gas bladder not strongly encapsulated in bone; a prominent pseudotympanum consisting of an area on the side of the body devoid of epaxial musculature where the gas bladder contacts the internal coelomic wall; short, blunt head without greatly elongated jaws; and smaller adult body size. Species of Tympanopleura are distinguished from each other on the basis of unique meristic, morphometric, and pigmentation differences. Ageneiosus melanopogon and Tympanopleura nigricollis are junior synonyms of Tympanopleura atronasus. Tympanopleura alta is a junior synonym of Tympanopleura brevis. A lectotype is designated for T. brevis. Ageneiosus madeirensis is a junior synonym of Tympanopleura rondoni. Tympanopleura atronasus, T. brevis, T. longipinna, and T. rondoni are relatively widespread in the middle and upper Amazon River basin. Tympanopleura cryptica is described from relatively few specimens collected in the upper portion of the Amazon River basin in Peru and the middle portion of that basin in Brazil. Tympanopleura piperata is distributed in the upper and middle Amazon River basin, as well as in the Essequibo River drainage of Guyana