[Bacterial endophthalmitis: retrospective clinical and microbiological study in Rabat Specialty Hospital]. / Endophtalmies bactériennes: étude rétrospective clinique et microbiologique à l'hôpital des spécialités de Rabat.

OBJECTIVES: To study and discuss the epidemiological, clinical, microbiological, and risk factors of bacterial endophthalmitis treated in the Rabat Specialty Hospital ophthalmology department. PATIENTS AND METHODS: This is a retrospective study over a period of 10 months of patients hospitalized for suspected acute infectious endophthalmitis. An intake form was completed for each patient. Each sample underwent direct examination and culture. All patients underwent the same protocol, providing for at least one intravitreal antibiotic injection and instillation of fortified eye drops. RESULTS: Twenty cases of endophthalmitis were recorded during the study period. Decreased visual acuity, intraocular inflammation, pain and conjunctival hyperemia were found in all patients. The median onset of symptoms was 4 days. Vitreous tap or anterior chamber paracentesis was performed in all patients. Bacteria were found in seven samples (40%). Gram positive organisms accounted for 85% of positive cultures. Amphotericin B was required in four patients, and systemic antibiotic therapy in ten patients. Corticosteroid treatment was administered secondarily in eight patients. DISCUSSION: In this retrospective series, epidemiological, clinical and microbiological data are consistent with those already published.

[Primitive aspergillosis of the posterior cerebral fossa in immunocompetent patient]. / Aspergillose primitive de la fosse cérébrale postérieure chez un patient immunocompétent.

Cerebral aspergillosis arises in the great majority of cases during an invasive aspergillosis with hematogene scattering from the lung hurts. The cerebral, not rare location is one of the worse criteria forecast during the invasive aspergillosis. We report the case of patient who was hospitalized in the neurosurgery department for syndrome of increased intracranial pressure, hemiparesis and cerebellar syndrome in febrile context. The radiological exploration objectified a collection of the posterior fossa. A stereotactic biopsy was performed. It collected fragments biopsy and pus. The pathological and microbiological analysis allowed the identification of Aspergillus fumigatus. The originality of this observation comes from the rare location in the posterior fossa of aspergillosis and because the patient is immunocompetent and no primary location is found. The patient presents however a viral hepatitis B of fortuitous discovery. He is put under treatment by amphotericin B. The evolution is marked by meningitis comment-diversion. Antibiotics are prescribed, and then the patient is operated for total ablation of the tumor. He dies following an osmolar coma associated with thrombopenia and a secondary renal insufficiency due to his treatment by the amphotericin B.