[Tumoral cutaneous form of kaposi's sarcoma: Diagnosis difficulties case report]

Kaposi's sarcoma is the most frequent neoplasia related to AIDS. We report here the difficulties of diagnosis and therapeutic of an atypical cutaneous form of Kaposi's sarcoma. A 31-year-old woman HIV- infected with severe immunodeficiency [CD4 cell count is 50 cell/mm[3] and HIV RNA viral load is 539000 copies /ml] was admitted for an atypical cutaneous kaposi's sarcoma. She was first treated by antiretroviral therapy combined stavudine, lamivudine and indinavir added to bleomycm monochimiotherapy. One month after, she developed persistent cough and new lesions of Kaposi sarcoma which a big pseudotumoral frontal one. Bronchoscopy showed pulmonary Kaposi's sarcoma. Polychimiotherapy [bleomycin, donorubicin et vinblastin], and local treatment were instituted with regression of lesions. Combined antiretroviral therapy, by increasing immune restoration, leaded to recovery

[Tuberculosis and acquired immunodeficiency syndrome]

From January 1987 to July 1990, 16,2% of patients followed with Human Immunodeficiency Virus [HIV] infection, of which six were ill [all with AIDS], had tuberculosis. Pulmonary tuberculosis was present in four patients [66,6%], and extrapulmonary tuberculosis in six. The extrapulmonary infections were located in the mediastinal lymph nodes in two cases, the peripheral lymph nodes in two cases, and in the pleura in two cases. Pulmonary infection was multilobar in four cases with cavitary infiltrates in one case. An intradermal skin test, using 10 TU PPD, was positive in only one case. The diagnosis of tuberculosis was confirmed by evidence of Mycobacterium Tuberculosis [MT] in direct examination in three cases, by cultures in the same three cases, and histology in four cases. Preliminary results of antibacterial treatment were favorable in five patients. However, these five patients died within an average of twelve months after diagnosis of tuberculosis, corresponding with the CDC which includes extrapulmonary tuberculosis in their case definition of AIDS. A study of a larger series would allow clarification of the epidemiological aspects of tuberculosis associated with HIV infection in Morocco

[Mediterranean spotted Fever. [64 observations]]

A retrospective study about 64 cases of Mediterranean Spotted Fever was conducted from January 1981 to November 1990. A pic of frequency was observed during summer [59%] with 26% of cases in July. 63% of patients were aged between 20 and 40 years. Males were more frequent than females [63%]. The contact with a dog was present in 14 cases [22%].Diagnosis was established in emergency only in 10 cases. A contact with a dog was found in 55% of cases. A treatment with cyclines or phenicoles was realised in all cases. None case of death was deplored. This retrospective study permits us to emphazise the frequency of Mediterranean Spotted Fever in our unit

[Clinical aspects and evolution of lymph node tuberculosis [77 Cases]]

Clinical Aspects and Evolution of Lymph Node Tuberculosis Between July 1981 and May 1990, 77 patients were hospitalized for tubercular adenopathy; the majority had a low economic status and only 7% had received the BCG vaccination. The infected lymph node was either isolated [n = 36] or associated with other infections the adenopathy was profond [n = 21] and / or more frequently peripheral [n = 72]. Cervical adenopathy was the most common. The tuberculin PPD test was positive in 61% of the patients. Wheras confirmation by diagnosis was available in 66 cases [86%]. Evolution following anti-tuberculosis treatment, with multiple therapies most often used, was favorable in 65 cases; treatment was unfavorable in 7 patients having multiple associated visceral infections

Serotypes and biotypes of Haemophilus influenzae responsible for meningitis. Report of an ampicillin resistent strain

Serotype b correspond to 99% of the strains of II. influenzae isolated in meningitis. The biotypes I and II are the most frequent. The authors report on the first betalactame producing strain isolated in Morocco