[Microscopic observation of bacteria on MGG stained blood smear in a patient with decompensated cardiac failure by infection]

The presence of inclusions miming cocci and bacilli on MGG stained blood smears is a routine event in laboratories. However, performing peripheral blood smear to detect microorganisms in context of sepsis is not recommended for diagnosis of bacteremia because of its low sensitivity compared to blood culture. Otherwise, the fortuitous detection of bacteria on MGG stained peripheral blood smear for leucocytes differentiating purpose represents an evidence of strong bacteremia frequently associated with poor prognosis. Before accepting a diagnosis of sepsis and bacterial involvement, we need to perform more investigations as well as blood cultures or free culture methods. In this way, we report a single case of a sever sepsis detected fortuitously on MGG stained blood smear for leucocytes differentiation by the presence of free and intra-leukocytes lengthened inclusions in a patient hospitalized in intensive care unit and dead for multi-visceral insufficiency despite the early wide spectrum antibiotic use then adapted antimicrobial therapy once microbiological results were provided

Nocardia brain abscess: a case report

Nocardiosis infections are rare, generally systemic, an occurring at the immuno compromised patient. The cerebral abscess with Nocardia is usually secondary to a pulmonary localization. Their bacteriological diagnosis and therapeutic management could be difficult. We report a case of cerebral abscess due to Nocardia in 47 years old patient treated with corticoids for a pulmonary confirmed sarcoidosis. He was hospitalized for a clinical feature in favour of an intra cranial expansive process. The diagnosis of Nocardiosis was suspected at direct examination of Gram stained smears and confirmed by the culture characteristics. The evolution was favorable after stereotaxic punction of the abscess and adapted antibiotherapy based on disc diffusion antibiogram. This observation emphasizes the interest of the bacteriological diagnosis for correct management of cerebral abscesses

[Clostriditm perfringens bacteraemia: a case report]

We report a case of resolutive bacteraemia due to Clostridium perfringens in an olderly patient with no predisposing factors or portal of entry. The patient presented a non specific infectious syndrome: high level CRP and fever; and was hospitalized for ischemic cardiopathy. Three cultures of peripheral blood have shown a growth in the first anaerobe one only, confirmed by the presence of Gram positive rods. Biochemical profile of the strain Api 20A [BioMerieux] allowed the identification of Clostridium perfringens at 99, 9%. The evolution under amoxicillin-clavulanic acid introduced before the second and the third blood culture permits a total recovering and disappearance of fever and pathologic levels of CRP

[Vaginal infections due to non-fastidious germs: place of Gardnerella vaginalis]

Gardnerella vaginalis is the most common frequently involved cause of bacterial vaginosis. The purpose of this study is to determine the frequency of G vaginalis infection among other non-fasidious etiological causes in women suffered from vaginosis diagnosed in our laboratory. Results were compared with data of literature, and discussed for guiding the best management of these infections. We analyzed the registered data of microbiological results of examined vaginal discharges over a period of three years.[2001-2003]. Positive diagnosis, of G. vaginalis vaginosis depends on the evident detection of clue cells microscopically in a Gram stained smears according to Amsels criteria. The results were often given in the same day. And as the current treatment depends on metronidazole, we rarely used culture sensitivity tests. Among 219 vaginal smears, 125 [57%] were positive, and 143 micro-organism incriminated- ni leukorrhoea were detected in our patients [210 out patient [96%] and [4%] inpatient]. Candida albicans was responsible for [28-19.6%], followed by G. vaginalis [23-16.1%] and lastly Escherichia coli [18-12.6%]. G. vaginalis-related vaginosis is frequent. It represents, the second etiological cause inducing vaginal discharge among the non-fastidious germs diagnosed in our hospital. As there is a recent reports show an in-vitro resistance and also the presence of a therapeutic failure using metronidazole in treating G. vaginalis infections, insistence of using a culture on an appropiate media in order to identify the germ and test sensitivity to antibiotics used in treating these infections must be performed following the simple way of laboratory detection