Association d’une pneumopathie à Chlamydia psittaci et d’une maladie de Horton

Some arguments are in favor of the role of Chlamydia in the pathogenesis of atherosclerosis and some vasculitis. Illustrating this possible relation, we report the case of a patient developing consecutively a Chlamydia psittacci infection and a temporal arteritis. A 73-years-old woman, with no significant medical history, was hospitalized for constitutionnal symptoms. Three weeks before, she described fever and sore throat during 2 days. Since that, she remained exhausted and developped a mild intermittent limp of the jaws. Clinical examination was poor. A biological inflammatory syndrome was noticed. X-ray chest revealed bilateral interstitial opacities. The titer of anti-C. psittaci antibodies was significant (positive IgG at 1/ 2048). Soon after initiation of doxycyclin, a temporal arteritis biopsy performed, due to the persistance of clinical symptoms and high inflammatory syndrom, concluded to the diagnosis of temporal arteritis. Corticotherapy was added to antibiotherapy resulting in decreasing of inflammatory syndrom and improvement of general status of the patient. X-ray opacities decreased in 3 weeks. Serological control after 3 months showed a decrease of the titer of anti-C.psittacci antibodies to 1/256, confirming the initial diagnosis of Chlamydia pneumopathy. Our observation could constitute one more argument for the role of bacteria like Chlamydia in the pathogenesis of vascular diseases. Prospective seroepidemiologic and molecular biology studies could allow to clarify the association between Chlamydia infections and inflammatory vasculitis like temporal arteritis.     

Contribution à l’étude de la mortalité dans un service d’urologie: Le cas du service d’urologie du CHU de Cocody d’Abidjan de 2000 à 2006

Objective

To analyze the incidence and main causes of mortality in the Department of Urology of the University Hospital of Cocody.

Patients and Methods

This retrospective analysis included 117 patients who died in the Department of Urology of the University Hospital of Cocody between April 2000 and December. Based on the data collected from the patient files, the hospital registry and the death certificates we studied the frequency and causes of death.

Results

The overall mortality rate was 10.1% with a male-to-female sex ratio of 14:1. The patients’ mean age was 63.4 (range 18–94) years. The main cause of death was cancer (87.5%). Cancer of the prostate which was the second most frequent reason for consultation after benign prostatic hyperplasia was the commonest cause of death encountered in 62.4% of the patients, followed by bladder and renal cancer with 16,2% and 6%, respectively. Prostatic adenoma (52%) was the most frequent and urethral stricture (8%) the third most frequent reason for hospitalization and led to death in 3.4% and 4.3%, respectively. Moreover, death mainly occurred in the second half of the month (53.9%) and during the night (57.3%).

Conclusion

The incidence of mortality in urology remains high and is almost exclusively related to urological cancers.     

Journée d’hiver de la SFMCP

Programme / Programme

Journée d’hiver de la SFMCP Samedi 12 décembre 2009     

Métastases osseuses d’un épendymome d’emblée de double localisation. À propos d’un cas

A case of cerebral and sacral ependymoma revealed by cerebellar syndrome and sciatica in a 68-year-old man is reported. Bone metastases were diagnosed seven months after surgical excision of the brain tumor.     

Thrombose d’oxygénateur en l’absence de résistance à l’héparine mais en présence d’une maladie de Vaquez

A 55-year-old male with a history of positive HIV serology and polycythemia vera underwent coronary artery bypass graft surgery with normothermic extracorporeal circulation. Following heparin administration the activated clotting time (ACT) was 633 seconds (Hemocron^® with kaolin). Lower than expected arterial and venous oxygen partial pressures together with high pressure (350 mmHg) in the arterial line upstream of the oxygenator were observed. Because of these signs the oxygenator was changed during the procedure. The outcome was uneventful. Electronic microscopic examination of the oxygenator membrane and thermic exchanger revealed fibrin and platelet deposits. Similar cases are described in the literature during polycythemia vera. Therefore the prevention might be a preoperative treatment with antiplatelet therapy in polycytemia vera.     

Profil hormonal chez l’homme en cas d’infertilité au laboratoire de radio immunologie de l’institut des radioisotopes de Niamey

ObjectiveThe aim of this study was to determine the sociodemographic parameters and hormonal profile of infertile man.Patients and methodsWe included in our study, all patients presenting with infertility dating back at least two years, with abnormal semen analysis. These patients came to radio immunological laboratory assays for determination of FSH, LH, PRL and testosterone in the assessment of infertility.ResultsThe age of the patients ranged from 25 years to 64 years with an average age of 44.5 years. Employees are the most represented with a frequency of 63.93%, with 54.41% had consulted a primary infertility, followed by traders in 15.63% and 70% for primary infertility. The hormonal assessment was abnormal in 86% of cases (55/64). A rise in FSH was observed in 36% of patients, the LH was elevated in 31.25% of patients, 48.44% in PRL. 12 patients (18.75%) had low testosterone Among the endocrinopathies suspected, the hypogonadism hypergonadotrophic is the most represented with a frequency of 32.8%, testicular deficiencies are found in 12.5% of cases, hypogonadism hypogonadotrophic in 10.93% of cases, hyperprolactinemia isolated in 18.75% of cases and obstructive causes in 14 04% of cases.ConclusionThere are many endocrinopathies that can induce male infertility. They can be congenital or acquired and can concern several stages, hypothalamus, pituitary and testis. It's important to diagnose thoses endocrinopathies, because some of them are accessible to treatment.