[Characteristics of invasive group B streptococcal infections in adults]

An obvious increase in the invasive due to group B streptocoque [GBS] in adult has recently been noted in several developed countries. Very few series describe the situation in developing countries. To determine the epidemiologic characteristics, the clinical features, the underlying conditions and the course of these infections observed in a Tunisian hospital. We retrospectively analysed 65 episodes hospitalized between 1993 and 2007. The sex-ratio was 0.3 and the mean age was 59 years. 73.8% of the patients had at least one risk factor. These factors were dominated by diabetes mellitus [40%] and recurrent urinary tract infections [25%]. Urosepsis, genital infections and bacteremia with no identified focus dominated the clinical manifestations. 13.9% of these infections were poly-microbial and all GBS isolates were sensitive to penicillin. The course was often favourable, 4.6% of the patients died and a recurrence of the invasive infection was noted in 7.7% of the cases. Our study shows a particular clinical spectrum of invasive group B Streptococcal infections in adults and confirms the role of underlying medical conditions. A Tunisian multi-centric study would specify the actual extent of these infections in our country

[Medical Management of Pott's disease: a review of 18 cases]

Vertebral tuberculosis is the most frequent osteo-articular location, surgical treatment is rarely indicate. The duration and the modalities of the medical treatment remain however subject to discussion. The purpose of this study is to propose a therapeutic attitude standardized for the pott's disease. The authors report a retrospective analysis of 18 cases of pott's disease. The mean age was 51 years. All the patients have a medical treatment, no surgical indications were carried. Magnetic resonnance imagery and biopsy under scanner allowed to avoid the surgical approach with aim diagnosis. The chemotherapy consisted of an attack phase associating four antituberculosis antibiotics of an average duration of 5 months, followed by a maintenance phase associating only two major antituberculosis antibiotics in daily grip and of an average duration of 11 months. Eight patients had a spinal cast immobilization. The mean follow up was 36 months. Clinical and anatomical evolution was favorable for all the patients. No neurological complication was noted. The antituberculosis medical treatment is always effective especially if diagnosis is premature and allows so to avoid appeal to the rather laborious surgery and results of which are not encouraging

[Primitive thyroid lymphoma: about 3 casese]

Primary thyroid lymphoma is a rare disease that often develops on a preexisting Hashimoto's thyroiditis. It is diagnosed because of a rapid growth of a goiter associated occasionally with signs of local compression. We report 3 cases of primitive thyroid lymphoma and we discuss its particular clinical aspects and the therapeutic modalities of this entity