Role of laboratory in diagnosis of multiresistance tuberculosis

Multiresistant tuberculosis associates a reduction in the sensitivity to isoniazid, the rifampicin and possibly to the other antituberculous ones. It is in constant progression in the whole world and constitutes a major problem of public health. The multiresistance seems to be the consequence of an inadequate former treatment [acquired resistance] or of a contamination by a stock from the start multiresistant [primary resistance]. The patients infected by the virus of the AIDS are a privileged target. New biological techniques are developed in order to identify the stocks resistant to antituberculous and to implement as soon as possible an adapted antituberculous treatment. Three processes are theoretically in competition for the fast antibiogram of Mycobacterium tuberculosis: - The direct antibiogram on solid medium remains the method of choice for the measurement of the sensitivity to antibiotics of second line in the event of multiresistance. - The Bactec method allows the culture and the identification of Mycobacterium tuberculosis in 8 days, then with additional 8 days, establishes the antibiogram with isoniazid, the rifampicine, the ethambutol and the streptomycine without making it possible to establish in a reliable way, the antibiogram facing antibiotics of second line. - The technique PCR [polymerase chain reaction] amplification of a segment of the gene followed by denaturation and hybridisation has been used for rapid detection of tuberculosis resistance

prothese totale de hanche dans les sequelles de coxalgie [4CAS]

The authors report 4 cases of total hip arthroplasty in patients with old tuberculosis of the hip. The hips were ankylosed. The fusion was badly tolered or initiated a decompensation in the neighbour joints. The arthroplasty was cemented. The biopsy was positive in one patient, negative in three patients. Only two patients were received antituberculosis agents. We have not noted relapse of tuberculosis after 3 years. The coverage with antituberculosis agent is recommented during 3-6 months

Enquete sur la frequence des teignes du cuir cheveu a fes

The prevalence of tinea capitis has been evaluated in Fes, a large moroccan city from a sample issued from the population of school children in preparatory, elementary [1 and 2] and medium [1 and 2] classes by random. Their age vary betwen 6 and 13 years. 600 are examined of 60.000 school children [i, e 0,1%] and submitted to clinical, direct and culture of hair scrapings. The results are: about 23% of children are affected and the trichophyties represent the main clinical cases [98% of positive cultures]. The girls are more involved than boys likwise the children 7 and 8 years old, and those issued from large families [more than 9 children]. Clinical examination constitue a orientation mean whereas, direct examination and culture of hair scrapings must be utilised simultaneourly in surveys