[Invasive infections neisseria meningitidis in children in Tunis: about 79 cases]

We conducted a retrospective study of meningococcal invasive diseases [MID] contracted in children in Tunis between January 1997 and January 2006. The purpose of this study is to specify the clinical, epidemiological, therapeutic and evolutionary features of these infections and to determine antimicrobial susceptibility and the antigenic formula of N. meningitidis isolates. During the study period, we have collected 79 cases of MID arising in children aged 3 days to 11 years. The majority of children's were less than of 4 years [57.3%]. We note a frequency of the MID in winter and in spring. The most frequent clinical shape was meningitis [53%]. Twenty one patients [26.6%] had a fulminant meningococcal disease. In our series, the rate of lethality was equal to 17.7%. Among the 46 meningococcal isolates, the most frequent serogroup was the B [73%] followed by C and A. A high heterogeneousness of the antigenic formulae was observed. The most frequent phenotype was NT: NST for the group B isolates and 4:P1.13 for the group C ones. N. meningitidis with reduced susceptibility to penicillin and to amoxicillin account for 54% and 10% of all isolates respectively. The cefotaxim and the rifampin were uniformly active

Traitement des insuffisances cardiaques refractaires par ultrafiltration extracorporelle

In order to precise the further and immediate effects of extracorporeal ultrafiltration [U.F.] during the refractory cardiac failures, a retrospective study has been performed. Ten patients, with phase III cardiac failure, presenting, 3 episodes of subclavian cathter U.F. These episodes have been well tolerated. The immediate results have been spectacular in 6 patients with a notable loss of weight, disapperance of aedemas, of functionnal gene and a resuming of diuresis. As to further resuls, 6 months later: 5 patients died, 2 were lost of sight and remaining three are keeping a stable cardiac state under a digitalo-diuretic and vasodilating treatment. In conclusion, during the refractory cardiac failure, the U.F. can give forth good results in the immediate, in wait for an eventual more appropriate treatment