[Urethral discharge in Morocco: prevalence of microorganisms and susceptibility of gonococcos]. / Les ecoulements urétraux au Maroc: prévalence des germes et sensibilité du gonocoque.

We studied 422 patients with urethral discharge recruited from 4 sentinel sites in Morocco to determine sociodemographic characteristics, history of STI infection, infecting organism and antibiotic susceptibility of Neisseria gonorrhoeae. The mean age of the sample was 28 years (range 16-67 years), and most were single, had multiple sex partners without taking protective measures and came from all social backgrounds; 59.9% had a history of a previous STI. The majority (87%) of the infections were the acute form. By polymerase chain reaction of urine samples of 399 patients, 41.6% had N. gonorrhoeae infection, 6.3% Chlamidia trachomatis and 10.8% both organisms; in 41.4% no organism was identified. N. gonorrhoeae was strongly susceptible to ciprofloxacin.

[Urethral discharge in Morocco: prevalence of microorganisms and susceptibility of gonococcos]

We studied 422 patients with urethral discharge recruited from 4 sentinel sites in Morocco to determine sociodemographic characteristics, history of STI infection, infecting organism and antibiotic susceptibility of Neisseria gonorrhoeae. The mean age of the sample was 28 years [range 16-67 years], and most were single, had multiple sex partners without taking protective measures and came from all social backgrounds; 59.9% had a history of a previous STI. The majority [87%] of the infections were the acute form. By polymerase chain reaction of urine samples of 399 patients, 41.6% had N. gonorrhoeae infection, 6.3% Chlamidia trachomatis and 10.8% both organisms; in 41.4% no organism was identified. N. gonorrhoeae was strongly susceptible to ciprofloxacin

[Cutaneous blastomycosis revealing a corticoadenoma]. / Blastomycose cutanée révélant un corticosurrénalome.

BACKGROUND: Blastomycosis is an uncommon chronic granulomatosis caused by Blastomyces dermatitidis. We present a case with a skin localization that disclosed malignant corticoadenoma. CASE REPORT: A 32-year-old man consulted for inflammatory nodules of the face and lower limbs. The histological examination of a nodule biopsy was in favour of blastomycosis. Ketoconazole treatment was ineffective. Amphotericin B provided cure of the skin lesions. Search for extension disclosed a malignant corticoadrenoma. DISCUSSION: Blastomycosis is very rare in Morocco. The portal is usually the lung. Unique skin involvement is very exceptional. To our knowledge this is the first report of a blastomycosis-corticoadenoma association. The clinical situation may be alarming in immunodepressed subjects. Amphotericin B treatment is indicated.

[Cutaneomucous tertiary syphilis]. / La syphilis tertiaire cutanéo-muqueuse.

On the basis of two new cases of cutaneous mucosal tertiary syphilis and a personal series of 30 cases observed at the University Hospital of Rabat and Casablanca from 1963 to 1980, we reviewed the clinical presentations of this disease. Late stage syphilis has not disappeared and appears to be increasing over the last decade. Lesions of the nervous system are increasingly reported in atypical often unrecognized forms. Cutaneous mucosal tertiary syphilis is very rare and little known and can take on the form of skin lesions suggesting tuberculosis, deep mycosis, sarcoidosis, leprosy or leishmaniasis. Based on our experience, we recall the variety of clinical presentations including superficial nodules and deep gommas leading to atrophic and rarely hypertrophic scars. The diagnosis relies essentially on the serology results which are always positive at a significant level. The pathology examination adds no essential information. Rapid response to treatment is one of the important criteria of the diagnosis of syphilis.

[Evaluation of 7 years of systematic surveys of leprosy in Morocco]. / Bilan de sept années d'enquêtes systématiques sur la lèpre au Maroc.

Between 1980 and 1987, 12 systematic surveys were made on a population of 254,979 people, of whom 236,868 were actually examined (92.61%). 422 suspected cases were identified i.e. a global detection rate of 1.66% of which only 241 reported to Aïn-Chock Hospital for further tests (55%). Out of these 241 suspected cases, 217 proved as having leprosy, i.e. a 90% correlation between the clinical suspicion and the biological identification. The 181 suspected cases who never reported to the hospital and the 16 leprosy patients whom we lost sight of constitute as a whole 46.68% of the suspected cases first identified. This shows an obvious lack of coordination between the local Authority and the medical service. The 185 confirmed cases of leprosy are shown in the table below and compared with those of the Central Statistical Office.

[Articular manifestations of Behçet's disease. Apropos of 65 cases]. / Manifestations articulaires de la maladie de Behçet. A propos de 65 observations.

The authors, in a series of 65 cases of Behçet's disease, notice 53% of rheumatological manifestations which are third in line after aphthosis and ocular disease. In order of decreasing frequency, it concerns arthritis (mono, oligo or poly-arthritis), arthralgias with an almost identical frequency, sacroiliitis, extraarticular involvement. These rheumatological manifestations are readily associated with necrotic pseudo-folliculitis and cutaneous aphthosis.

[Ganglioneuroblastoma of the orbit]. / Ganglioneuroblastome de l'orbite.

Ganglioneuroblastoma a transitional tumor of sympathetic origin has not yet been described as involving orbit. It is characterized by a mixture of cells ranging from primitive neuroblast to well differentiated ganglion cells within a neurofibromatous tissue. The prognosis is uncertain, as the tumor may either undergo maturation into a ganglioneuroma or may metastasize widely and rapidly as in neuroblastoma. We may postulate a relationship between ganglioneuroblastoma and Recklinghausen's neurofibromatosis in view of the development of the tumor in conjunction with the phacomatosis.

[Cowden's disease. Syndrome of multiple hamartomas]. / La maladie de Cowden. Syndrome des hamartomes multiples.

Cowden's disease is a phacomatosis (multiple hamartomas), which is a familial, hereditary, dominant autosomal affection presenting as typical buccolabial mucocutaneous lesions associated with digestive tract polyps. Differential diagnosis of the predominantly digestive form of the disease is polyposis. A new case of this rare disorder is reported, only 62 cases being documented in literature.

[Trabeculectomy in the treatment of congenital glaucoma. Apropos of 74 cases]. / La trabéculectomie dans le traitement du glaucome congénital. A propos de 74 cas.

The authors report the results obtained in 74 cases, or 105 eyes, with congenital glaucoma operated on by trabeculectomy. Three different trabeculectomy procedures were used: closing the scleral flap with two sutures; placing a silastic passing in bridge under the flap; and tightly suturing the scleral flap. The last mentioned method gave the best results. This was related to intervention during the first phase of the disease and minimizing damage to the cornea. It is derived from this study that the mechanism of action of a trabeculectomy is more an "opening" of the paths of physiological drainage than filtration via the sub-conjunctival space.

[Serological cardiolipid development of early syphilis treated with a single injection of benzathine-penicillin of 2,400,000 I.U]. / L'évolution sérologique cardiolipidique de la syphilis précoce traitée par une injection unique de benzathine-pénicilline de 2.400.000 U. I.

For one year, the authors have observed the clinical and biological development of early syphilis on 205 patients infected between 1971 and 1979 and treated by a single injection of Benzathine-Penicilline of 2,400,000 U.I. The serological negativeness has been obtained in the proportions as follow: - 91,43 p. 100 of primary syphilis (blood test positive), - 88,57 p. 100 of secondary syphilis, - 67,69 p. 100 of latent syphilis. These results compared to those obtained by other more time-consuming and expensive methods, can be considered as satisfactory.

[Optic neuropathy in acute poisoning with methanol]. / Neuropathies optiques au cours d'une intoxication aiguë par le méthanol.

The authors report four cases of methanol poisoning, two of which suffering acute bilateral optic neuropathy which secondarily leads to optic atrophy. The report the main clinical features of such a poisoning and the actual basis of its physiopathology and treatment. According to the four cases reported, they underline the importance of early diagnosis and specific treatment.