Subject(s)
Bronchi , Foreign Bodies/epidemiology , Larynx , Trachea , Adolescent , Adult , Child , Child, Preschool , Endoscopy/methods , Female , Gabon , Hospitals, Teaching , Humans , Male , Retrospective Studies , Tracheotomy/methods , Young AdultABSTRACT
OBJECTIVE: The aim of this study was to analyze the predisposing factors and the diagnostic and therapeutic aspects of diffuse cervico-facial cellulitis. MATERIAL AND METHODS: This retrospective study examined the records of all 32 patients admitted to the ENT and cervico-facial department of the Omar Bongo Ondimba Army Teaching Hospital in Libreville with diffuse cervico-facial cellulitis, from January 2006 through December 2010. RESULTS: The study included 18 women (56%) and 14 men (44%) with a mean age of 28 years. At admission, 28 patients (87.5%) had already received anti-inflammatory drugs and 25 (78%) one or more antibiotics. Two patients were HIV+. The main route was dental for 21 patients (66%), tonsillar for 4 (13%), submandibular for 2 (6%), parotid for 2 cases (6%), cutaneous for 1 (3%) and unspecified in 2 more (6%). The cellulitis was pseudo-phlegmonous in 24 patients (75%) and gangrenous in 8 cases (25%). It extended to the mediastinum in six patients (19%). The bacteriological study, carried out in 24 cases (75%), found 14 cases of aerobic germs. Medical or medical and surgical treatment led to cure for 30 patients (94%). Two patients (6%) died. CONCLUSION: Treatment of cervico-facial cellulitis must be early and multidisciplinary. Self-medication with anti-inflammatory drugs for bucco-pharyngeal infections without appropriate antibiotic treatment is the principal predisposing factor.
Subject(s)
Cellulitis/microbiology , Stomatognathic Diseases/microbiology , Adult , Cellulitis/therapy , Female , Focal Infection, Dental/complications , Gabon , Humans , Male , Retrospective Studies , Stomatognathic Diseases/therapyABSTRACT
OBJECTIVES: To analyse the epidemiological, diagnostic and therapeutic aspects of cervical lymph node tuberculosis (TB) in Libreville. MATERIAL AND METHODS: This retrospective descriptive multicentre study included all 140 patients with complete files who were treated for cervical lymph node TB from 2001 through 2006, regardless of whether TB was found at any other site. RESULTS: A slight predominance of men was observed. The infected lymph nodes were most often located at the posterior triangle of the neck. Histological proof was obtained for 81 patients. We recorded 94 cures, 4 cases of therapeutic failure, 34 patients lost to follow-up and 8 deaths. CONCLUSION: Cervical lymph node tuberculosis is a common ailment. Excisional lymph node biopsy has a twofold interest -therapeutic and diagnostic. It is based on histological examination, which must henceforth be systematic. Tuberculosis is a major HIV-related opportunistic infection and must be screened for or monitored at every HIV check-up.
Subject(s)
Tuberculosis, Lymph Node/diagnosis , Tuberculosis, Lymph Node/epidemiology , Adult , Antitubercular Agents/therapeutic use , Female , Gabon/epidemiology , HIV Infections/epidemiology , Humans , Male , Neck , Retrospective Studies , Tuberculosis, Lymph Node/drug therapyABSTRACT
OBJECTIVE: To review the pathologic, diagnostic and therapeutic aspects of the cranioencephalic complications of bacterial sinusitis. MATERIAL AND METHODS: This retrospective study included children who underwent diagnostic imaging at the Omar Bongo Ondimba military hospital between January 2006 and December 2010 and treatment of cranioencephalic complications of sinusitis. RESULTS: During the study period, 58 children were hospitalized with sinusitis, and eight (13.8%) had cranioencephalic complications for an annual incidence of 1.6% and a sex ratio of 5 boys to 3 girls. Their mean age was 13 years. Symptoms developed over a mean duration of 14 days (range: 3-45 days). The clinical picture was dominated by febrile headaches and neurologic signs. Palpation of the sinus pressure points was painful in all cases. Disorders of consciousness were found in five cases, with a mean Glasgow score of 9 (range: 7-13). Seven children had multifocal sinusitis and one frontal sinusitis. Five children had a subdural empyema, two associated with thrombophlebitis of the sagittal sinus, one with a brain abscess with thrombophlebitis of the sagittal sinus, and another with meningitis and thrombophlebitis of the sagittal sinus. Two children had osteomyelitis of the frontal sinus table, including a frontal lobe abscess for one. Another had multiple cerebral abscesses. Five children had sinus and neurosurgical drainage, two sinus drainage only, and one neurosurgical drainage only. Microbiology was positive for microbes in four cases: Streptococcus eqinus (one case), Staphylococcus aureus (one case), both S. pneumoniae and Haemophilus influenzae (one case), and Aerococcus viridans (one case). Outcome was favourable in seven cases, including four without sequelae. Two children had recurrences, and one died. CONCLUSION: Diagnosis of the cranioencephalic complications of sinusitis rely on medical imagery. Early multidisciplinary therapeutic management is essential.
