Bulletin de la Societe de pathologie exotique et de ses filiales最新文献

148 adult patients with chronic diarrhoea and suspected to be HIV infected have had stool examinations. 46 are without any enteric parasite. Those detected in the others patients are Sporozoans: I. belli (16.2%) and Cryptosporidium sp. (6.7%) found alone or joint, together or with other parasites. Among those, all Flagellate species are identified, but T. intestinalis (6%) is predominant. Entamoeba coli (8.%) is the most frequent amebic species, however, E. histolytica histolytica have been found twice, once singly, the second associated with I. belli, Schistosoma mansoni and Candida albicans. Necator americanus (14%) and Strongyloides stercoralis (12%) are the predominant worm species. Among the yeasts, C. albicans (35.8%) is the most important species isolated, singly in 13.5% of the patients. In an intertropical and parasitical endemic area where many parasites are not considered uncommon, opportunist agents as I. belli, Cryptosporidium sp. and C. albicans appear in an non-negligible frequency in our study.

During and after a Rift Valley fever (RVF) epidemic in Southern Mauritania we collected 600 clinical observations. 348 were confirmed to be RVF cases. We described 5 major clinical aspects: mild, icteric, icterohemorrhagic, hemorrhagic and neurological forms. The first one is the most frequently seen with 42.8% of the cases at admission. Fever was associated with various pains (cephalalgia, myalgia, arthralgia) and an important asthenia. Inconsistently this syndrome was accompanied by epistaxis and conjunctival hyperemia. The icteric form, never described before, is an icterus occurring during evolution of a mild form. It represents 28.5% of total cases at admission. The great number of theses mild forms implies that they could be used as excellent markers for an epidemic emergence.

A 13-year old Yemeni boy who presented with flaccid paraplegia was thought to have a spinal cord tumor on myelography. Microscopic examination of surgically excised material revealed bilharzial granulomas. Brief review of relevant literature on schistosomiasis of the spinal cord, with particular reference to the Middle East, is presented.

Frequency distribution of leishmanin test survey in Dhamran valley around Taez (Yemen Arab Republic) is reported. It was carried out on 174 school children from 6 to 12 years old. Three schools located at 950 m, 1,100 m and 1,430 m of altitude were visited. The maximum of positivity is observed in the lower range where L. tropica, L. donovani and L. infantum are rife. In the upper valley, where cutaneous leishmaniasis is rare and visceral leishmaniasis absent, the rate of positivity is a little bit lower. The conjugated influence of the three parasites is suggested.

A 76 year old patient is admitted in an intensive care unit with severe acute pneumococcal meningitis. He dies 2 days after admission besides antibiotherapy by ampicillin. Interest of measures for preventing the infections after lumbar puncture is discussed.

Because importance of Campylobacter jejuni/coli in human disease, we studied frequency, clinical and biological symptoms of Campylobacter enteritis. Investigation has been realised on 216 cases of diarrhoea seen outside the hospital and aged from 4 days to 60 years, and 512 cases of hospitalised diarrhoea. Outside the hospital, this bacteria has the same frequency as Shigella and Salmonella (3-5%). Inside the hospital, it is rare. Outside the hospital, this bacteria is isolated in babies and children. Inside the hospital, it affects children and adults. In the hospital, clinical and biological symptoms of Campylobacter enteritis are more serious: Campylobacter predominant in stools, presence of leukocytes for all patients, and no other pathogenic organisms associated.

A young woman living in a malaria endemic area in West Africa, was contaminated twice with placental infection by Plasmodium falciparum, in two successive pregnancies. No parasites were observed on blood smears both in mother peripheral blood and in cord blood. A parasitemia was described in the intervillous space in the placental. The first placental infection was attributed to a febrile illness ten days before the end of gestation. No reliable symptoms of malaria were found for the second infection. Treatment for fever during pregnancy were given, at 6 and 9 months for the first gestation, and at 4 months for the second gestation. Investigations are correlated with the age of the two placental infections, the second infection is a very young and synchronous parasitemia. No foetal diseases, no low birth weight o congenital malaria were observed on newborns during the both gestations.

Life at high altitude presents very interesting biological and medical aspects. For countries such as the Andeans, it also has socio-economical implications. The most important towns of Bolivia are situated between 3,000 and 4,850 m. It's to say that a great percentage of the population is permanently staying there. Moreover owing to the improvement of the roads and transport, an extensive migration (professional life, business, tourism, sport) developed some years ago. At 3,000 to 4,850 m, an oxygen arterial pressure (PaO2) between 40 and 70 mm Hg is resulting from the environmental hypoxia. The adaptation to hypoxia takes place in two phases: --that incomplete, observed at short time in people who recently arrived, --that at very long time, observed in the native. The rapid arrival at more than 3,000 m, exposes the traveller to an hypoxic ventilatory stimulus which produces a hyperventilation response to increased PaO2. This hyperventilation brings out a decreasing of carbon dioxide arterial pressure (PaCO2) and alkalosis of the blood. This respiratory alkalosis seems to be responsible for most troubles which are present in the Acute Mountain Sickness linked to the CO2 role in cerebral blood circulation. At the same time but more slowly the classical high altitude polycythemia develops which permits compensate partially the hypoxic effect in 3 to 4 weeks. In the native the adaptation implies physiological variations of some parameters concerning the individual development. The principal studies showed that the native present a notable hyposensitivity to hypoxia and also to the stimulus CO2-H+. The Chronic Mountain Sickness patients have a less sensitivity to the same stimuli than the natives.

The systematic inventory and annual following of Phlebotomus population is established by the authors in a transmission area of visceral (human and canine) and cutaneous (human) leishmaniasis in the Yemen Arab Republic (province of Taez). Seven species of Phlebotomus and nine species of Sergentomyia are thus identified. Among them, four are considered as potential vectors: on the one hand, P. orientalis (s.g. Larroussius) and, probably P. arabicus (s.g. Adlerius) for L. infantum and L. donovani, in the other, P. sergenti and P. saevus (s.g. Paraphlebotomus) for L. tropica.

Among 172 strains collected in Yaoundé 60% are chloroquine-resistant, 37% are amodiaquine-resistant, instead of quinine and mefloquine which are completely efficient. Among 30 strains collected at a rural health center (where self treatment decreases), 27% are chloroquine-resistant. New therapeutic schemes for first and second line treatment in endemic areas must be evaluated.