Tuberculous and Brucellar Spondylodiscitis: Comparative Analysis of Clinical, Laboratory, and Radiological Features

Methods@#A retrospective study was conducted using the data of all patients hospitalized for TS and BS in the infectious diseases department between 1991 and 2018. @*Results@#Among a total of 117 patients, 73 had TS (62.4%) and 44 had BS (37.6%). Females were significantly more affected with TS than males (56.2% vs. 22.7%, p<0.001). Fever (72.7% vs. 45.2%, p=0.004) and sweating (72.7% vs. 47.9%, p=0.009) were significantly more frequent among patients with BS. The median erythrocyte sedimentation rate was significantly higher in the TS group (median, 70 mm/hr; interquartile range [IQR], 45–103 mm/hr) than in the BS group (median, 50 mm/hr; IQR, 16–75 mm/hr) (p=0.003). Thoracic involvement was significantly more frequent in the TS group (53.4% vs. 34.1%, p=0.04), whereas lumbar involvement was significantly more frequent in the BS group (72.7% vs. 49.3%, p=0.01). Initial imaging findings revealed significantly higher frequencies of posterior vertebral arch involvement, vertebral compaction, and spinal cord compression in the TS group. Percutaneous abscess drainage (20.5% vs. 2.3%, p=0.005) and surgical treatment (17.8% vs. 2.3%, p=0.01) were more frequently indicated in the TS group, with a significant difference. @*Conclusions@#A combination of clinical, laboratory, and radiological features can be used to distinguish between TS and BS while these patients await diagnosis confirmation.

Haemophagocytic lymphohistiocytosis secondary to Plasmodium falciparum malaria: Case report and review of the literature

Rationale: Haemophagocytic lymphohistiocytosis is a rare complication of malaria, which is often misdiagnosed. Patient concerns: A 30-year-old male was admitted to our department for persistent fever, which began after returning from a stay in Guinea-Conakry. The laboratory investigations revealed a pancytopenia and an elevated C-reactive protein. Peripheral smear examination showed Plasmodium falciparum, therefore confirming the diagnosis of malaria. The laboratory tests showed a worsening pancytopenia. Bone marrow aspiration and biopsy revealed images of hemophagocytosis. Diagnosis: The diagnosis of haemophagocytic lymphohistiocytosis complicating malaria infection was established. Interventions: The patient was treated with artemether-lumefantrine. No immunosuppressant treatment was delivered to the patient. He received antipyretic and antimalarial treatment only. Outcomes and lessons: We report a case of haemophagocytic lymphohistiocytosis trigged by malaria infection and we review all reported cases secondary to Plasmodium falciparum malaria by searching PubMed publications till October 2019. Haemophagocytic lymphohistiocytos secondary to malaria should be suspected even in non-severe cases of malaria. Hammami Fatma 1 Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax Koubaa Makram 2 Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax Chaari Mourad 3 Hematology Laboratory, Hedi Chaker University Hospital, University of Sfax Chaabouni Rim 4 Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax Zeyni Abrakhom 5 Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax Rekik Khaoula 6 Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax Smaoui Fatma 7 Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax Jemaa Mounir 8 Infectious Diseases Department, Hedi Chaker University Hospital, University of Sfax Nascimento TL do, Vasconcelos SP, Peres Y, Oliveira MJS de, Taminato M, Souza KMJ de. Prevalence of malaria relapse: Systematic review with meta-analysis. Rev Lat Am Enfermagem 2019; 18(27): e3111. 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Challenges in the diagnosis of hemophagocytic lymphohistiocytosis: Recommendations from the North American Consortium for Histiocytosis (NACHO). Pediatr Blood Cancer 2019; 66(11): e27929. Harioly Nirina MOM, Raheritiana TM, Harioly Nirina MOJ, Rasolonjatovo AS, Rakoto Alson AO, Rasamindrakotroka A. Hemophagocytic lymphohistiocytosis associated with Plasmodium falciparum. Med Mal Infect 2017; 47(8): 569-570. Niang A, Niang SE, Ka EHF, Ka MM, Diouf B. Collapsing glomerulopathy and haemophagocytic syndrome related to malaria: A case report. Nephrol Dial Transplant 2008; 23(10): 3359-3361. Ohnishi K, Mitsui K, Komiya N, Iwasaki N, Akashi A, Hamabe Y. Clinical case report: Falciparum malaria with hemophagocytic syndrome. Am J Trop Med Hyg 2007; 76(6): 1016-1018. Ladeb S, Ben Abdejlil N, Fakhfakh N, Lakhal A, Belloumi D, Ben Hamed L, et al. 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Haemophagocytic lymphohistiocytosis syndrome-related to severe malaria: rare association. Tunis Med 2014; 92(7): 515-516. Santos JA, Neves JF, Venâncio P, Gouveia C, Varandas L. Hemophagocytic lymphohistiocytosis secondary to Falciparum malaria in a 5 year-old boy. Ann Hematol 2015; 94(1): 161-163. Vinoth PN, Thomas KA, Selvan SM, Suman DFR, Scott JX. Hemophagocytic syndrome associated with Plasmodium falciparum infection. Indian J Pathol Microbiol 2011; 54(3): 594-596. Dass R, Barman H, Duwarah SG, Choudhury V, Jain P, Deka NM, et al. Macrophage activation syndrome in malaria. Rheumatol Int 2010; 30(8): 1099-1101. Sermet-Gaudelus I, Abadie V, Stambouli F, Hennequin C, Lenoir G, Gendrel D. Haemophagocytic syndrome in Plasmodium falciparum malaria. Acta Paediatr 2000; 89(3): 368-369. Zvulunov A, Tamary H, Gal N. Pancytopenia resulting from hemophagocytosis in malaria. Pediatr Infect Dis J 2002; 21(11): 1086-1087. Sanklecha M, Mehta N, Bagban H. Varied presentation of complicated falciparum malaria in a family. Indian Pediatr 2012; 49(5): 413-414. Abdelkefi A, Ben Othman T, Torjman L, Ladeb S, Lakhal A, Belhadj S, et al. Plasmodium falciparum causing hemophagocytic syndrome after allogeneic blood stem cell transplantation. Hematol J Off J Eur Haematol Assoc 2004; 5(5): 449-450. Rehman JU, Bhabri N, Waleed A, Maulawi A, Aslam M. Falciparum malaria in a patient with sickle cell trait with hemophagocytosis and secondary pancytopenia. Ann Hematol 2012; 91(8): 1329-1330. Retornaz F, Seux V, Arnoulet C, Durand JM, Sainty D, Soubeyrand J. Plasmodium falciparum malaria infection complicated by haemophagocytic syndrome in an old man. Acta Haematol 2000; 103(4): 224-225. Anwar M, Saleem M, Malik IA. Severe haemophagocytic syndrome in falciparum malaria. JPak Med Assoc 1995; 45(11): 302-303. Ohno T, Shirasaka A, Sugiyama T, Furukawa H. Hemophagocytic syndrome induced by Plasmodium falciparum malaria infection. Int J Hematol 1996; 64(3-4): 263-266. Epelboin L, Rapp C, Faucher JF, Mechai' F, Bottieau E, Matheron S, et al. Management and treatment of uncomplicated imported malaria in adults. Update of the French malaria clinical guidelines. Med Mal Infect 2020; 50(2):194-212. Tothova Z, Berliner N. Hemophagocytic syndrome and critical illness: New insights into diagnosis and management. J Intensive Care Med 2015; 30(7): 401-412. Malinowska I, Machaczka M, Popko K, Siwicka A, Salamonowicz M, Nasilowska-Adamska B. Hemophagocytic syndrome in children and adults. Arch Immunol Ther Exp (Warsz) 2014; 62(5): 385-394.

rare cause of dysphagia in a pregnant woman: herpes simplex esophagitis

Herpes simplex esophagitis [HSE] has rarely been reported in immunocompetent individuals. In a search of Medline until October 2012, we found only one case of HSE in a pregnant female. We present the first case of HSE in a healthy 36-year-old female at 27 weeks gestation who recovered without antiviral therapy

Deep vein thrombosis associated with acute brucellosis: a case report and review of the literature

No abstract available.