[Six cases of actinomycosis]

Actinomycosis is a rare granulomatosis infection caused by anaerobic bacteria; Actinomyces. There are many locations of actinomycosis and they can simulate an inflammatory or malignant process or pyogenic infection. We report 6 cases of actinomycosis. The diagnosis was confirmed by an anatomopathologic exam. The evolution was marked by an improvement after prolonged antibiotic treatment. This study shows the difficulties in the diagnosis of actinomycosis and the importance of systematic histopathological examination

[First four cases of acute meningitis due to Toscana virus on monastir region]

Toscana virus [TOSV] has been identified as an important cause of acute meningitis in Italy where it was isolated for the first time. Currently, it is one of the major viral pathgens involved in acute meningitis in Mediterranean countries. We describe four cases of acute meningitis caused by TOSV concerning patients hospitalized in the department of infectious diseases, Fattouma Bourguiba university hospital, Monastir [Tunisia]. The demographic data, the clinical and laboratory features and the evolution were reviewed. All patients were male, living in coastal region. They were hospitalized in summer period. The mean age was 26 years. The diagnosis was suspected in the presence of fever and acute meningitis syndrome. Lumbar puncture showed clear cerebrospinal fluid [CSF] containing normal glucose and predominant lymphocyte. This diagnosis was confirmed by detection of anti-TOSV IgM in blood and CSF. The outcome was favorable in all cases. No specific treatment was administered. The mean follow-up was nine months

Intestinal strongyloidiasis rebelled at albendazole in immunocompetent patient: a case report

Interest of ivermectine in Strongyloides stercoralis infection rebelled at a treatment by albendazole. We report an intestinal infection case of Strongyloides stercoralis in 60-year-old immunocompetent women. The diagnosis of Strongyloides stercoralis was suspected on clinical parameters and performed by parasitologic analysis of feces. The outcome was defavourable under treatment by albendazole. Although, clinical and laboratory findings resolved after ivermectine therapy. Ivermectine is the main treatment in intestinal strongyloldiasis rebelled at treatment by albendazol

Facial cellulitis as a complication of a periradicular abscess due to Gemella morbillorum

Gemella morbillorum is a facultatively anaerobic Gram-positive coccus which forms part of the normal flora of the oro-pharynx, the upper respiratory and gastrointestinal tracts. It rarely causes human infection, more often in immunocompromised hosts. We report a case of periradicular abscess due to Gemella morbillorum occurring in a young immunocompetent adult and review previous reports of infections due to Gemella morbillorum in the literature

[Antimicrobial susceptibilities of emterobacteriaceae isolated from urinary tract infections in the area of Monastir]

The aim of this study is to determinate the local epidemiology of urinary tract infections in the university hospital of Monastir and to evaluate antimicrobial susceptibility of most incriminated Enterobacteriaceae strains since 2002 to 2005. Identification of strains was based on conventional bacteriological features. Susceptibility to antibiotics was studied according to the Antibiogram Committee of the French Microbiology Society recommendations. In total, 8505 Enterobacteriaceae strains were isolated including Escherichia coli [76%] followed by Klebsiella spp. [10.5%] and Proteus mirabilis [4%]. For E. coli and P. mirabilis, resistances rates were respectively 61% and 71% to amoxicillin, 46.4% and 45.5% to the combination amoxicillin-clavulanic acid, and 39.6% and 26% to cotrimoxazole. Strains of Klebsiella spp. were resistant to cefotaxim and amoxicillin + clavulanic acid in respectively 42% and 20% of cases. Finally, from 2002 to 2005, a significant increase in Enterobacteriaceae resistance was observed for ofloxacin, from 11.9% to 17.6% and ciprofloxacin, from 9.1% to 14.5%. The emergence of antimicrobial resistance justifies that empiric treatment of urinary tract infections should be revised regularly

[Breast tuberculosis: study of 15 cases]

Mammary tuberculosis is a rare disease especially seen in underdeveloped countries. Describe the epidemiological, clinical parameters of mastitis tuberculosis and determinate the interest of imagery and histology in diagnosis. Fifteen cases of tuberculous mastitis diagnosed at the Infectious Diseases and Gynaecology departments of F. Bourguiba hospital during the period from January 1988 to March 2006. The mean age of our patients was 29.2 years [21 - 56 years]. History of tuberculosis was found in 33.3% of the cases. Sixty percent presented with fever and 73.4% complained of skin abscess. We noted symptoms of tuberculosis impregnation in 53.3% of cases. The fine needle aspiration achieved for all patients was negative in 14 cases and brought back the caesium in the other. The diagnosis has been made, for all our patients, after histological study when we found typical tuberculosis lesions on pieces of tumorectomy or biopsy. All patients had an anti-tuberculosis medical treatment. The median duration of treatment was 10 months [9 -18 months]. Although tuberculosis of breast is extremely rare, it should be kept in mind particularly in undeveloped countries. In front of symptoms evoking tuberculosis, biopsies must be done to eliminate an eventual cancer

[Drug rash with eosinophilia and systemic cymptoms [DRESS syndrome] associated with sulfasalazine and human herpesvirus 6 infection successfully treated with steroid therapy]

We report a case of a 30-year-old man who developed a generalized erythematous skin eruption, fever, lymphadenopathy, hepatic cytolysis and eosinophilia probably due to sulfasalazine. Indirect immunofluorescence assay for Human herpesvirus-6 [HHV-6] was positive, supporting recent HHV-6 infection. The patient was successfully treated with dexamethasone. The case is reported with a review of the literature. DRESS syndrome mechanisms and management are also discussed