Articular manifestations associated with HIV infection

During the infection by human immunodeficiency virus, there is dysfunction in the immune system because of the coexistence of immundeficiency and immune hyperactivity, and a disregulated production or activity of cytokines. Some of these mechanisms explain the development of articular manifestations associated with HIV infection Highly active anti retroviral therapy has changed the spectrum of the HIV-associated articular manifestations. New syndromes have emerged. A variety of disorders may be seen. Their prevalence is controversed. Several points remain obscures such as the existence of genetical predisposition for these manifestations, the role played by the anti retroviral therapy and utilisation of immunosuppressors like inhibitors of TNF alpha

[ leptospirosis: clinical, biological and therapeutic study]

The Leptospirosis is an obligatory declared infectious disease, caused by a bacteria type spirochaete

Objectives: Analyse the clinical, biological and therapeutical characteristics of cases of leptospiral infection in the department of the internal medicine at CHU Ibn Sina, Rabat

Patients and Method: It was a retrospective study that begins in january 2000 still décember 2004.The inclusive criterions based on the epidemic circumstances orientated to the leptospirosis and the clinical and biological evokating arguments

Results: Seventeen cases were studied. Average age of the patients is 38 years old [28 years to 64 years] sex ratio of 7, 5 with predominance masculine. Contamination is related to of profession or exposure in a public bath in all the cases. The diagnostic period was 7-8 days. Clinically; icterus appears as a constant symptom, fever founded in 88% of the cases and hepatic cytolysis in 70% of the cases [transaminases are 2 times superior then the normal]. Renal insufficiency and thrombocytopenia are noted respectively in 58, 8% and 47% of the patients On the therapeutic plan; all patients benefited from parenteral rehydration. Thirteen patients benefited from a therapy based on Penicillin G; four patients were treated by Ampicillin parenteraly. One patient had presented with a mucocutaneous allergic reaction from Penicillin G at a 4 of the treatment so he had put on Cyclins. The average duration of hospitalization is 12, 5 days. Evolution was favourable in all patients

Conclusion: The diagnosis of leptospirosis must be evoked in all common cold [acute coryza] accompanied by hepatic cytolysis, renal insufficiency without thrombocytopenia. In the absence of serological proof, the clinical polymorphism of this disease makes the diagnosis sometimes difficult