Tetanus is an infection caused by Clostridium tetani. The disease has been described from the earliest medical literature. Despite this old knowledge, the existence of a vaccine, and the progress made in pathophysiolo...Tetanus is an infection caused by Clostridium tetani. The disease has been described from the earliest medical literature. Despite this old knowledge, the existence of a vaccine, and the progress made in pathophysiology and treatment, tetanus remains a real public health problem, particularly in developing countries. Tetanus in children and adults is still a frequent cause of hospitalization in the Infectious and Tropical Diseases Department (SMIT) of the Fann National University Hospital (CHNU). We conducted this study with the main objective of carrying out a situational analysis of tetanus at SMIT from 2010 to 2017. We recorded 706 cases of tetanus in a total of 8123 hospitalized patients. The median age of the patients was 23 years [1 - 90 years]. The sex ratio (M/F) was 4/1. More than half (58.78%) came from suburban areas. The population was most frequently made up of students (24%) or manual workers (22.1%). At least one comorbidity was present in 107 patients (15.15%). The absence of a vaccination record was found in 99.56%. The main portal of entry was integumentary (83.3%), post-circumcision (5.7%) and otogenous (4%). Tetanus was generalized in 93.9% of cases. The main signs of tetanus found were trismus and dysphagia. Patients were most frequently classified as stage II (78.7%). Antibiotic therapy was based on metronidazole (51.41%). Anti-tetanus serotherapy was carried out by sub-occipital administration in 97.6%. Tracheostomy was performed in 48 patients. Complications occurred in 226 patients (32.01%). The main complications were respiratory (53.98%), infectious (45.13%) and cardiovascular (41.59%). The average delay in hospitalization was 3.6 ± 3.4 days. The mean length of hospital stay was 11.9 ± 8.2 days. The hospital case-lethality rate was 18.98%. Despite the decline in cases over the years in our country, tetanus remains a public health problem because of its prevalence, severity, and lethality.展开更多
Background: Ovarian tuberculosis is a rare form of tuberculosis. Its clinical presentation mimics an ovarian tumor, leading to misdiagnosis. Proper treatment with anti-tuberculosis drugs can lead to a cure for the dis...Background: Ovarian tuberculosis is a rare form of tuberculosis. Its clinical presentation mimics an ovarian tumor, leading to misdiagnosis. Proper treatment with anti-tuberculosis drugs can lead to a cure for the disease but can sometimes cause adverse effects that compromise therapeutic management. Observation: We report a 71-year-old female Senegalese patient who presented with a chronic abdominopelvic mass with an elevated Cancer Antigen 125 (CA125) level, raising the suspicion of an ovarian tumor. She underwent an exploratory laparotomy and the anatomopathological study confirmed the diagnosis of ovarian and peritoneal tuberculosis. After starting treatment with anti-tuberculosis drugs, she developed toxidermia in the form of generalized urticaria. Discontinuation of the four-drug therapy and separate reintroduction of anti-tuberculosis drugs led to the incrimination of rifampicin. Progress was then favorable on Isoniazid (H) pyrazinamide (Z) and Ethambutol (E). Conclusion: Ovarian tuberculosis should be suspected in the presence of an abdominopelvic mass in a woman living in an endemic area. The occurrence of adverse reactions to anti-tuberculosis treatment is not uncommon, hence the importance of regular monitoring.展开更多
Laryngeal tuberculosis is a rare form of extrapulmonary tuberculosis, often complicating pulmonary tuberculosis that may be unrecognized. Its clinical presentation is nonspecific, often pointing to cancer. We report t...Laryngeal tuberculosis is a rare form of extrapulmonary tuberculosis, often complicating pulmonary tuberculosis that may be unrecognized. Its clinical presentation is nonspecific, often pointing to cancer. We report the case of a 77-year-old woman, with no reported pathological history. She also has no alcohol or tobacco intoxication, who presented with chronic dysphonia evolving for 2 months, associated with an altered general condition. The examination of the larynx by direct laryngoscopy and anatomical pathology study of the biopsies led to the diagnosis of laryngeal tuberculosis. A search for secondary sites revealed a concomitant pulmonary infection. The evolution was favorable under standard anti-tuberculosis treatment, with complete voice recovery and improved performance status. Laryngeal tuberculosis should be suspected in patients living in endemic areas and suffering from chronic dysphonia, even if they are not alcoholics or smokers.展开更多
文摘Tetanus is an infection caused by Clostridium tetani. The disease has been described from the earliest medical literature. Despite this old knowledge, the existence of a vaccine, and the progress made in pathophysiology and treatment, tetanus remains a real public health problem, particularly in developing countries. Tetanus in children and adults is still a frequent cause of hospitalization in the Infectious and Tropical Diseases Department (SMIT) of the Fann National University Hospital (CHNU). We conducted this study with the main objective of carrying out a situational analysis of tetanus at SMIT from 2010 to 2017. We recorded 706 cases of tetanus in a total of 8123 hospitalized patients. The median age of the patients was 23 years [1 - 90 years]. The sex ratio (M/F) was 4/1. More than half (58.78%) came from suburban areas. The population was most frequently made up of students (24%) or manual workers (22.1%). At least one comorbidity was present in 107 patients (15.15%). The absence of a vaccination record was found in 99.56%. The main portal of entry was integumentary (83.3%), post-circumcision (5.7%) and otogenous (4%). Tetanus was generalized in 93.9% of cases. The main signs of tetanus found were trismus and dysphagia. Patients were most frequently classified as stage II (78.7%). Antibiotic therapy was based on metronidazole (51.41%). Anti-tetanus serotherapy was carried out by sub-occipital administration in 97.6%. Tracheostomy was performed in 48 patients. Complications occurred in 226 patients (32.01%). The main complications were respiratory (53.98%), infectious (45.13%) and cardiovascular (41.59%). The average delay in hospitalization was 3.6 ± 3.4 days. The mean length of hospital stay was 11.9 ± 8.2 days. The hospital case-lethality rate was 18.98%. Despite the decline in cases over the years in our country, tetanus remains a public health problem because of its prevalence, severity, and lethality.
文摘Background: Ovarian tuberculosis is a rare form of tuberculosis. Its clinical presentation mimics an ovarian tumor, leading to misdiagnosis. Proper treatment with anti-tuberculosis drugs can lead to a cure for the disease but can sometimes cause adverse effects that compromise therapeutic management. Observation: We report a 71-year-old female Senegalese patient who presented with a chronic abdominopelvic mass with an elevated Cancer Antigen 125 (CA125) level, raising the suspicion of an ovarian tumor. She underwent an exploratory laparotomy and the anatomopathological study confirmed the diagnosis of ovarian and peritoneal tuberculosis. After starting treatment with anti-tuberculosis drugs, she developed toxidermia in the form of generalized urticaria. Discontinuation of the four-drug therapy and separate reintroduction of anti-tuberculosis drugs led to the incrimination of rifampicin. Progress was then favorable on Isoniazid (H) pyrazinamide (Z) and Ethambutol (E). Conclusion: Ovarian tuberculosis should be suspected in the presence of an abdominopelvic mass in a woman living in an endemic area. The occurrence of adverse reactions to anti-tuberculosis treatment is not uncommon, hence the importance of regular monitoring.
文摘Laryngeal tuberculosis is a rare form of extrapulmonary tuberculosis, often complicating pulmonary tuberculosis that may be unrecognized. Its clinical presentation is nonspecific, often pointing to cancer. We report the case of a 77-year-old woman, with no reported pathological history. She also has no alcohol or tobacco intoxication, who presented with chronic dysphonia evolving for 2 months, associated with an altered general condition. The examination of the larynx by direct laryngoscopy and anatomical pathology study of the biopsies led to the diagnosis of laryngeal tuberculosis. A search for secondary sites revealed a concomitant pulmonary infection. The evolution was favorable under standard anti-tuberculosis treatment, with complete voice recovery and improved performance status. Laryngeal tuberculosis should be suspected in patients living in endemic areas and suffering from chronic dysphonia, even if they are not alcoholics or smokers.
