Les infections à Listeria monocytogenes à Tunis: à propos de sept cas

Listeria monocytogenesis a Gram positive facultative intracellular bacterium that can be responsible for severe infections, affecting essentially pregnant women, immunocompromised patients at the early and later stages of life. In Tunisia, invasive L. monocytogenes infections are thought to be exceptional and limited data are available about listeriosis. We reported seven cases (five newborn children and two infants) of human listeriosis that occurred in Tunis from 2000 to 2008. The newborn children were hospitalized for suspicion of maternofoetal infections. The two infants were hospitalized for fever associated with digestive signs in one case and neurological signs in the other. L. monocytogenes-was isolated from culture of cerebrospinal fluid in four cases, peripheral samples in two cases and from blood culture in one case. Isolates identification was based on conventional methods. Antimicrobial susceptibility was realized according to the recommendation of the “Comité de l’antibiogramme de la Société française de microbiologie”. All L. monocytogenes isolates were sensitive to amoxicillin and aminoside but resistant to 3rd generation cephalosporins. Investigations of the immune system were realized for the two infants including phenotypic analysis of peripheral blood cells by flow cytometry, lymphocyte proliferation assays, phagocytic cell functions and measurement of immunoglobulins as well as complement. All these explorations were normal for both infants. The outcome was fatal in only one case (a newborn child), and all the other patients recovered after adapted antibiotic treatment. In conclusion, our study shows that listeriosis is not exceptional in Tunis. Thus, it is necessary to know how to evoke this diagnosis, at any age, in order to establish an early and adapted antibiotic treatment and to avoid fatal outcome.     

Morsures de serpent à l’hôpital national de Niamey: à propos de 53 cas

This study was aimed at assessing envenomations caused by snakebite in Niamey National Hospital, between July 2005 and September 2006. We included 53 victims of snakebites. The wounded distribution indicated more wounded males than females (sex ratio = 1.78:1). The mean age was 29 ± 17 years. September to November seemed a period of higher risk. The snake was not identified in 60% of the cases. The bite occurred during March in 43% of the cases. Clinically, 6% of the patients showed no signs of envenomation and 7% presented bleeding disorders; 88% of the patients did not receive anti-venom. The lethality rate was 15%.