Mesenteric abscess caused by chryseobacterium meningosepticum is an extremely rare clinical entity, most often found in immunodeficient patients. Castleman disease can manifest as a mesenteric ...abscess. We here report the case of a 23-year-old patient admitted with generalized acute peritonitis evolving over the last 2 weeks. Abdominal ultrasound showed hypoechoic mass in the intestinal loops, without any further details. During laparotomy, pus was found in the large cavity, a mesenteric abscess was detected in the mesentery of the jejunum 35 cm from the angle of Treitz, without loop perforation and mesenteric adenopathy was found in corresponence with the abscess. Pyoculture isolated chryseobacterium meningosepticum. Histological analysis of mesenteric adenopathy biopsies showed structural anomalies, suggesting hyaline vascular type of Castleman disease. Treatment was based on incision and drainage of the abscess, with pyogenic membrane removal and abdominal cavity lavage with physiological saline solution. Chryseobacterium meningosepticum was only susceptible to Ciprofloxacin. The postoperative course was simple and the patient was discharged on postoperative day 10 after surgery. Clinical and paraclinical follow-up at 12 months did not show any other lymphadenopathy or recurrence. The purpose of this study is to show an extremely rare case of mesenteric abscess due to chryseobacterium meningosepticum associated with isolated mesenteric Castleman disease in an immunocompetent patient and management approaches.
Un abcès mésentérique causé par le Chryseobacterium meningosepticum est une entité clinique extrêmement rare, le plus souvent retrouvé sur un terrain d´immunodéficience et la maladie de Castleman ...peut être révélée par un abcès mésentérique. Nous présentons le cas d´un patient de 23 ans admis pour péritonite aiguë généralisée évoluant depuis 2 semaines. L´échographie abdominale montrait une masse hypoéchogène dans les anses grêles sans donner des plus amples détails. A la laparotomie, du pus avait été retrouvé dans la grande cavité et un abcès mésentérique présent dans le mésentère jéjunal à 35 cm de l´angle de Treitz sans aucune ouverture de l´anse en regard mais également une adénopathie mésentérique en regard de l´abcès. La pyoculture a isolé le Chryseobacterium meningosepticum et l´adénopathie mésentérique enlevée a montré à l´analyse histologique des anomalies structurales évoquant le type vascularisation hyalinisée de la maladie de Castleman. Le traitement a consisté en une incision et drainage de l´abcès avec résection de la coque et un nettoyage de la cavité abdominale au sérum physiologique. La Ciprofloxacine était le seul antibiotique sensible au Chryseobacterium meningosepticum. Les suites post-opératoires étaient simples avec sortie du patient au 10
e
jour post-opératoire. Un suivi clinique et paraclinique du patient pendant 12 mois n´a objectivé aucune autre adénopathie ni aucune récidive. Le but de cette publication est de présenter un cas extrêmement rare associant un abcès mésentérique à Chryseobacterium meningosepticum et une maladie de Castleman unicentrique à localisation mésentérique chez un immunocompétent ainsi que les modalités de cette prise en charge.
hydrocephalus is a progressive distension of the anatomical spaces (ventricles and subarachnoid space) containing the cerebrospinal fluid. It most commonly affects children. In developed countries, ...its prevalence and incidence are estimated between 0.9 to 1.2 per 1000 and 0.2 to 0.6 per 1000 live births respectively and between 50 000 and 100 000 new cases develop each year in the world. The purpose of this study was to describe the clinical, paraclinical and therapeutic features of hydrocephalus in 4 medical facilities in Lubumbashi.
we conducted a descriptive cross-sectional study at the University Clinics of Lubumbashi, Cinquantenaire Hospital, Sendwe General Reference Hospital and ARS Clinic from April 1
, 2015 to September 30
, 2019. Data were collected on the basis of a data collection sheet containing several study parameters including age, sex, clinical signs, birth weight, patient's history, head circumference, CT scan assessment and disease progression. Our sample consisted of 91 subjects with hydrocephalus.
the age group 29 days to 24 months (infant) was most commonly affected, i.e. 57.14%, with a sex ratio of 1.67 and a male predominance. The main detecting sign was macrocrania in all patients, followed by setting-sun sign in 53.85% of patients. Brain CT scan was performed in all patients and 65.92% of them had tetraventricular hydrocephalus. Ventriculoperitoneal shunt was performed in all patients. There were no deaths in the postoperative period; postoperative infectious and mechanical complications accounted for 8.79% and 4.40% respectively. The average length of stay in the hospital was 5.65 days.
hydrocephalus is the most common reason for pediatric neurosurgery. Clinicians should focus on these results which highlight the importance of early diagnosis and proper management.
Notre travail vise à rapporter, la place de la chirurgie à ciel ouvert dans la reprise d´une sténose urétérale étendue, ancienne et post infectieuse d´une part, et d´autre part, d´apporter notre ...expérience thérapeutique, cela à travers l´observation d´un patient âgé de 38 ans qui nous avait consulté dans notre service d´urologie des cliniques universitaires de Lubumbashi, pour douleur lombaire gauche, brûlures mictionnelles, fièvre sans horaire, Le bilan clinique et paraclinique, mettaient en évidence la sténose urétérale étendue. Une dérivation urinaire temporaire (urétérostomie gauche) était réalisée. Il a été repris, pour une urétérectomie suivie d´une réimplantation urétéro-vésicale gauche. Les suites postopératoires ont été simples, le patient a été revu 3 mois après l´intervention, il n´avait aucune plainte, la créatinine contrôle était normale, l´échographie et l´uroscan étaient dans les normes.
Chancre mou Agharbi, Fatima-Zahra
The Pan African medical journal,
07/2019, Letnik:
33, Številka:
185
Journal Article
Recenzirano
Odprti dostop
Notre travail vise à rapporter un cas de carcinome urothelial vésical qui est une tumeur rare chez les sujets de moins de 40 ans, et apporter notre expérience thérapeutique, cela à travers ...l'observation d'un patient âgé de 37 ans, avec antécédent d'infection urinaire et un séjour dans une région riveraine (bilharziose) ayant consulté pour hypogastralgie et hématurie totale macroscopique. Le bilan clinique et paraclinique, mettait en évidence une volumineuse masse tumorale vésicale d'allure infiltrante, sans envahissement ganglionnaire ou organique local ou à distance. Sa prise en charge chirurgicale a consisté en une exérèse biopsique tumorale vésicale suivie d'une cystectomie totale, avec enterocystoplastie iléale de substitution. Les suites opératoires ont été simples. Il avait bénéficié egalement d'une chimiothérapie adjuvante et une vitaminothérapie B12. Les contrôles cliniques et paracliniques effectués 6 et 12 mois ne montraient aucune récidive.
infections are the leading cause of morbidity and mortality in patients with sickle cell disease, especially before age 5 years. The purpose of this study was to highlight the epidemiological ...features, etiologies and management of osteoarticular infections in patients with sickle cell disease in Lubumbashi.
we conducted a descriptive, cross-sectional and retrospective study at the Research Center for Sickle Cell Disease in Lubumbashi (RCSCDL) over a three-year period from June 2014 to June 2017. It included all patients with sickle cell disease on follow up at the RCSCDL who developed osteoarticular infection. Data were obtained from a survey form. Parameters were patient's age, age at first visit, sex, reason for consultation, history, physical signs, diagnosis, paraclinical assessment and treatment.
we identified 35 cases of osteoarticular infections out of a total of 380 cases of sickle-cell disease, reflecting a rate of 9.2%. The most affected age group was people under 5 years of age (37.1%); the average age was 10.9±9.5 years ranging from 8 months and 37 years. There was a slight female predominance (51.4% of cases; sex ratio 1.06 in favor of women). Most patients with osteoarticular infection had a history of transfusion (16.6%) and splenectomy (8.6%). The most common reason for consulting was limb pain (84%); 20 patients (57.1%) had bulbar conjunctival icterus and 26 (74.3%) were pale. Clinical examination showed limb swelling and wound in 27 patients (77.1%) and 19 patients (54.3%), respectively. Clinical palpation of the splenomegaly was performed in 6 patients (17.1%). Three types of osteoarticular infections were detected. They were dominated by osteomyelitis (24 cases; 68.57%) followed by osteitis (7 cases; 20%) and suppurative arthritis (4 cases; 11.43%). Out of 24 cases of osteomyelitis, 18 were acute (75%) and 6 were chronic (25%), of which 4 had a hyperostosing behaviour and 2 a fistulising behaviour. Tibia was the most affected bone (18 cases), X-ray mainly showed osteolysis (27 cases; 77.1%) and then periosteolysis (15 cases; 42.9%). Homozygous sickle cell disease was found in 88.6% of cases. Hemoculture was performed in 17 out the 35 patients and salmonella was isolated in 15 out of 17 cultures (88.23%). Pyoculture was performed in 10 patients; it isolated other germs. Assessment of inflammation was performed in 21 patients: 15 had hyperleukocytosis, 13 pathological white blood cell formula , all had increased sedimentation rate (greater than 20mm in the 1st hour). With respect to immunization schedule, 62.86% of patients received EPI vaccines while patients with sickle cell disease who needed specific vaccine had an adherence rate of 17.14%. With respect to therapy, all of our patients received medical treatment; 6 patients underwent sequestrectomy (17.14%) while the majority of patients (25 cases) underwent orthopedic treatment.
bone infection in patients with sickle cell disease is a worryng issue in our poor environment where there isn't a specific vaccine for patients with sickle cell disease.
Anorectal malformations (ARM) are developmental anomalies of the genitor anal elements, they represent a wide range of anomalies. An early diagnosis allows a better management as it reduces mortality ...associated with ARM, especially in developing countries. A prospective cross-sectional study has been carried, including patients from 0 to one year, admitted in our service for ARM. Twenty-four (24) patients have been considered. The median age was 2 days, the sex ratio 1/3 for female. Intestinal occlusions were the most frequent circumstances of diagnosis (50%), low ARMs were the most frequent, diagnosed in 11 patients (45.7%) of which 10 did not have any fistula. The most common associated malformation was intestinal atresia (3 patients). Anoplasty was done using abdominoperineal pull-through associated to anal dilatations in 13 patients (54.1%). Six patients died from unknown etiology and 6 were lost from the follow-up. Concerning the functional outcome, 12 of the 24 patients concerned by the study attended review and 3 of them presented signs of fecal incontinence, 9 of them were continents among whom 8 were diagnosed low ARM and one with high ARM. ARMs are encountered in our environment, nonetheless, the diagnosis is still made most of the time, during an intestinal occlusion. The mortality rate is still high and measures should be taken to allow long-term reviews, which will surely reduce the number of lost patients.
La fermeture chirurgicale primaire dans le traitement de l´omphalocèle géante est émaillée des complications. Le traitement conservateur est une option adaptée aux pays à faible revenu où la ...chirurgie te la réanimation néonatales sont pourvoyeuses d´une grande mortalité. Ceci est une étude prospective menée aux cliniques universitaires de Lubumbashi, incluant les patients reçus entre janvier et avril 2020 et qui ont bénéficié d´un traitement conservateur à l´éosine aqueuse disodique selon un protocole défini. Trois patientes ont été inclues dans notre série. L´âge moyen était de 24 heures (1 - 48), toutes nées à terme (38 - 39 SA), et par voie basse, sans aucun diagnostic anténatal posé. La moyenne du poids de naissance était de 2.800 grammes (2.400 - 3.000). Le diamètre moyen du sac était de 13,7 cm (11 - 15 cm), le sac contenant le foie dans tous les cas. Le délai moyen de nutrition entérale était de 4,3 jours (4 - 5 jours), celui de granulation était de 31,7 jours (30 - 33 jours) et celui d´épithélialisation était de 71,7 jours (60 - 90 jours). Aucun décès n´a été déploré. Ces résultats préliminaires encouragent l´utilisation de l´éosine aqueuse disodique dans le traitement conservateur des omphalocèles géantes non rompues.
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