[Acute severe asthma in infants. Study of 34 cases]

Acute severe asthma is the most severe acute complication of infant asthma. The aim of our study was to specify its characteristics in the Tunisian infant and analysis his initial medical care. It is a retrospective study included 34 infants less than 3 year old, admitted during the period from January 1, 1995 to December 31, 2000. The acute severe asthma was induced by a respiratory viral infection in 80 % of cases. The delay hospitalisation was upper than 48 hours in 56 % of the cases. Before admission, corticosteroids were not instituted in 84 % of the cases. The initial examination noted neurological disorders in 52 % of cases and hemodynamic disorders in 8 % of cases. All patients received beta2 adrenergic and intravenous corticosteroids. Intravenous aminophylline was used in 68 % of patients. Mechanical ventilation was necessary among 6 patients. The evolution was complicated: pneumothorax (3 cases), hypokaliemia (3 cases), inappropriate secretion of ADH syndrome (1 case). There were 2 deaths. Acute severe asthma forces a correct evaluation of the severity of the asthmatic disease in order to adapt the long-term therapy.