Abdominal actinomycosis: about four cases

The abdominal actinomycosis [AA] is a rare and often unrecognised suppurative chronic illness. It is caused by an anaerobic positive Gram bacteria; Actinomyces israeli Abdominal actinomycosis is responsible of pseudotumoral syndrome in the most of the time leading in the doubt of a neoplasia, to a large and mutilating extraction surgery whereas a prolonged treatment by antibiotics would have permitted to heal the illness. The diagnosis is obtained generally from anatomopathologic exam. We report 4 cases of abdominal actinomycosis being revealed by a pseudotumoral syndrome. The diagnosis has only been made after surgery. In spite of an active treatment by antibiotics during several months, two of our patients had recidivism of their actinomycosis. These 4 observations confirm the diagnostic and therapeutic difficulties already reported by other authors

[Chronic HBS antigen carriers casually discovered - evolutionary aspects about 221 adults]

Hepatitis B virus infection constitutes a health public problem notably in our country where the frequency of chronic HBs antigen carriage is about 5%. Most of these patients are asymptomatic and so underestimated. Study epidemiological characters and clinical, biological and virological profile of chronic HBs Ag carriers whose discovery was fortuitous. retrospective study of 221 patient's files where HBs Ag was casually discovered: blood donors [128], pregnant women [40], exposition to risk factor [24], familial inquiry [23] and prenuptial examination [6]. average age was 31 years with a male predominance. Among the hepatitis risk factors found: high frequency of multiple syringes use and scarifications. All patients were asymptomatic with a normal physical exam. Prevalence of anti-HCV antibodies was 0,28% and that of anti-HDV 9,3%. A moderate cytolysis was noted in 14 patients [6,3%] and about 2/3 of them had positive markers of viral replication [HBe Ag+ and/or DNA+]. HBe antigen was positive in 12,7% of cases. Average duration of follow-up was 20,7 months. Three patients made spontaneous conversion HBe Ag/anti-HBe, and one conversion HBs Ag/anti-HBs. Hepatic biopsy was practised in 8 patients with cytolysis and showed 3 cirrhosis and 5 chronic hepatitis. Conclusion : despite favorable evolution of these patients, a clinical and biological supervision is necessary to search cytolysis and/or viral replication requiring then more agressive management