[Epidemio-clinical aspects of bacterial acute infant Pneumopathies at Yalgado Ouédraogo University Health Center]. / Aspects Epidemio-Cliniques des Pneumopathies Aiguës Bacteriennes de L'Enfant Au Chu Yalgado Ouedraogo.

INTRODUCTION: Infections of low respiratory tracks represent a public health issue and are a frequent reason for antibiotic prescription . For children in Africa, they are the main morbidity factor (50% of visits) and mortality (about 20% of infant mortality). Actually, the antibiotherapy, mainly probabilistic, rests on the awareness of the epidemiology of the germs which are responsible in a given region, at a given period. The purpose of this study was to evaluate the Epidemio-clinical aspects of bacterial acute infant Pneumopathies at Yalgado Ouédraogo Univercity Health Center. PATIENTS AND METHOD: This a descriptive retrospective study, base on the files of hospitalized patients in the Paediatric Unit of CHU YO from January 1, 2005 through December 31, 2006. RESULTS: All in all, 5803 patients with 658 cases of acute bacterial pneumopathy (11.3%) were hospitalized in the paediatric unit. Besides, acute bacterial Pneumopathies, 254 patients had another associated affection. Proteino-calorific malnutrition were frequent (59.7%), coupled with anaemia (36%). The reported most frequent germs are respectively: Streptococcus pneumoniae (29.3%), Klebsiella pneumoniae (29.3%) et Staphylococcus aureus (25%). The streptococcus was sensitive to association amoxicilline + clavulanic in 66.7% of the cases, to ceftriaxone in 57.1 % of cases. It was 100% resistant to ampicilline and to amoxicilline. The clinical evolution of our patients was favorable in 90% of the cases with 5.5% deaths. CONCLUSION: Pneumopathies affect mostly children who are less than 2 years old favored by malnutrition and anaemia. The high morbid-morbidity related to this pathology could be improved through a better awareness and regular updating of local bacterial ecology.

[Epidemio-clinical aspects of adult acute bacterial pneumonia at Yalgado Ouédraogo University Health Center]. / Aspects Epidemio-cliniques des Pneumopathies Aiguës Bacteriennes de L'Adulte au Chu Yalgado Ouedraogo.

INTRODUCTION: Bacterial Pneumopathies are low respiratory infections due to parenchyma pulmonary attack, which etiologic agent is a bacteria different from tubercular bacillus. Factually, the treatment is based on a probalistic antibiotherapy. This requires awareness of the epidemiology of the germs which are responsible in a given region, at a given period. PATIENTS AND METHOD: In order to better grasp mainly the bacteriological and therapeutic aspects of adult bacterial Pneumopathies in Burkina Faso, we have come up with a two year journal/documentary. RESULTS: The reported most frequent germs are respectively: Streptococcus pneumoniae (32,6%), Klebsiella pneumoniae (21%) et Staphylococcus aureus (13,9%). Negative Gram bacteries represented 53.5% of isolated germ and Acinetobacter was found only with HIV positive patients. The streptococcus was sensitive to association amoxicilline + clavulanic in 91.7% of the cases, to ceftriaxone in 83.3% of cases, to ampicilline and to amoxicilline in 66.7% of cases The clinical evolution of our patients was favorable in 74.5% of the cases with 21.8% deaths. The evolution was more significant within alcoholic patients (p = 0.001) as well as tobacco addicted patients (p = 0.02). CONCLUSION: The high morbi-morbidity due to acute pneumopathy could be improved through a better awareness and regular updating of local bacterial ecology.

Aspects épidémio-cliniques des pneumopathies aigues bactériennes de l'adulte au CHU Yalgado Ouedraogo

Introduction : Les pneumopathies bactériennes sont des infections respiratoires basses par atteinte du parenchyme pulmonaire, dont l'agent étiologique est une bactérie autre que le bacille tuberculeux. En pratique, le traitement repose sur une antibiothérapie probabiliste. Ce qui requiert une connaissance de l'épidémiologie des germes responsables dans une région donnée, à un moment donné. Patients et méthode : Ainsi afin de mieux appréhender essentiellement les aspects bactériologiques et thérapeutique des pneumo-pathies bactériennes de l'adulte au Burkina Faso, nous avons réalisé une revue documentaire de deux ans. Résultats : Les germes les plus fréquemment identifiés ont été respectivement Streptococcus pneumoniae (32,6%), Klebsiella pneumoniae (21%) et Staphylococcus aureus (13,9%). Les bactéries Gram négatif ont représenté 53,5% des germes isolés et l'Acinetobacter n'a été retrouvé que chez les patients à sérologie VIH positive. Le streptocoque a été sensible à l'association amoxicilline + acide clavulanique dans 91,7% des cas, à la ceftriaxone dans 83,3% des cas, à l'ampicilline et à l'amoxicilline dans 66,7% des cas. L'évolution clinique de nos patients a été favorable dans 74,5% des cas et soldé par un décès dans 21,8% des cas. L'évolution était significativement plus défavorable chez les patients éthyliques (p=0,001), ainsi que les malades tabagiques (p=0,02).Conclusion : La forte morbi-morbidité par pneumopathie aigue pourrait être améliorée grâce à une meilleure connaissance et à une mise à jour régulière de l'écologie bactérienne locale

Aspects epidemio-cliniques des pneumopathies aigues bacteriennes de l'enfant au CHU Yalgado Ouedraogo

Introduction : Les infections des voies respiratoires basses constituent un probleme de sante publique et sont un motif tres frequent de prescription d'antibiotiques . Chez les enfants d'Afrique; elles sont le principal facteur de morbidite (50des causes de frequentation des structures sanitaires) et de mortalite (environ 20de la mortalite infantile). En pratique; l'antibiotherapie; generalement probabiliste; repose sur la connaissance de l'epidemiologie des germes responsables dans une region donnee; a un moment donne. Le but de cette etude etait de d'evaluer les Aspects epidemio-cliniques des pneumopathies aigues bacteriennes de l'enfant au CHU Yalgado Ouedraogo. Patients et methode : Il s'agit d'une etude retrospective de type descriptif; portant sur les dossiers des patients hospitalises dans le service de Pediatrie du CHUYO du 1er janvier 2005 au 31 decembre 2006. Resultats : Au total; 5.803 patients dont 658 cas de pneumopathies aigues bacteriennes (11;3) ont ete hospitalises dans le service de Pediatrie. En plus de la pneumopathie aigue bacterienne; 254 patients ont presente une autre affection associee. La malnutrition proteino-calorique etait la plus frequente (59;7); suivie de l'anemie (36;6). Les germes les plus frequemment identifie ont ete respectivement Streptococcus pneumoniae (29;3); Klebsiella pneumoniae (29;3) et Staphylococcus aureus (25). Le streptocoque a ete sensible a l'association amoxicilline + acide clavulanique dans 66;7des cas; a la ceftriaxone dans 57;1des cas. Il a ete resistant a 100a l'ampicilline et a l'amoxicilline. L'evolution clinique de nos patients a ete favorable dans 90des cas et solde par un deces dans 5;5des cas. Conclusion : Les pneumopathies touchent surtout les enfants de moins de 2 ans avec un terrain debilite par la malnutrition proteino-calorique et l'anemie. La forte morbi-mortalite liee a cette pathologie pourrait etre amelioree grace a une meilleure connaissance et a la mise a jour reguliere de l'ecologie bacterienne locale

[Contribution of bronchial fibroscopy in pneumonology services in developing countries]. / Apport de l'endoscopie bronchique dans un service de pneumologie d'un pays en développement.

Bronchial fibroscopy is a recent investigation method that requires equipment and facilities difficult to implement in respiratory diseases units in developing countries. In Burkina Faso, this technique was introduced for the first time in February 1997. The purpose of this study was to determine the contribution of bronchial fibroscopy for the diagnosis of respiratory disease in countries with limited resources. This study was conducted between February 1997 and October 1998 at the respiratory diseases unit of the Yalgado Ouedraogo National Hospital Center in Ouagadougou, Burkina Faso. Thirty-five cases of tuberculosis were diagnosed, including 29 cases with bronchial node involvement, where bronchial fibroscopy is an essential diagnostic examination, and 6 cases of bacteriologically proven pulmonary tuberculosis. Ten cases of lung cancer were diagnosed (40% squamous cell carcinoma). Malignant disease is a reality in developing countries despite low rates of diagnosis due to insufficient diagnostic facilities. For tuberculosis, the importance of specific treatment is certainly well established and should always be initiated, even if fibroscopy cannot be performed. This contrasts with the situation for malignant disease, where the high prevalence of lung cancer (9.9% of the bronchial fibroscopies performed) is associated with total lack of treatment due to the absence of a thoracic surgery unit or a radiotherapy unit, and the impossibility of providing satisfactory surveillance of anti-cancer chemotherapy.

[Primary pulmonary myxoid liposarcoma discovered fortuitously]. / Liposarcome myxoïde pulmonaire primitif de découverte fortuite.

We report a fortuitous discovery of primary pulmonary myxoid liposarcoma in an HIV-positive patient. Primary pulmonary localizations are uncommon. Generally, pulmonary localizations are metastatic. There is a male predominance and diagnosis is generally made around 40 years of age. The two main features of liposarcoma are the large tumor size and the complex histology that evolves over time. Pathology findings are rarely reproducible and vary from one pathologist to another. Macroscopically, liposarcomas can mimic benign tumors. The risk of recurrence is high after simple enucleation due to microscopic extracapsular extensions. Surgery remains the predominant treatment. Wide complete excision, if possible, provides long-term survival.

[Clinical, radiographic and ultrasonographic aspects of mediastinal nodular tuberculosis in the era of HIV infection]. / Aspects cliniques, radiologiques et endoscopiques de la tuberculose ganglionnaire médiastinale.

OBJECTIVE: The purpose of this study was to determine the clinical, radiographic, and ultrasonographic aspects of mediastinal nodal tuberculosis and ascertain its clinical course in the era of HIV infection. PATIENTS AND METHODS: We reviewed retrospectively 39 patients referred to the Ouédraogo Yalgado National Hospital Center and the National Anticancer Institute between February 1996 and December 1999 for mediastinal nodal tuberculosis. Endoscopic proof of tuberculosis was obtained in 30 cases (81.8%). HIV serology was positive in 26 of the 30 patients tested (86.6%). RESULTS: Nodal mediastinal tuberculosis accounted for 1.7% of the cases of tuberculosis recorded over the same period at the Anticancer Institute. Mean age of the patients was 32.8 years and the sex ratio was 1.05 in favor of men. Clinically, a past medical history was found in 18 cases (46%) including a herpes zoster in 6 (15.4%), cough in 38 (97.5%). Weight loss (95%), fever (100%) and peripheral node enlargement (20%) were found frequently, probably related to HIV infection more than tuberculosis. Radiographically, standard x-rays evidenced associated lesions in 22 cases, with 59% having predominant parenchymatous lesions. Other localizations of tuberculosis were very frequent (42.5%). DISCUSSION: Bronchial fibroscopy is most contributive to diagnosis of mediastinal nodal tuberculosis with an 81.8% yield in our series. HIV infection had a determining effect on the disease course since among the 16 patients who died, 14 were HIV-positive (52%).

[Caseous pneumonia in a 14-month-old infant]. / Pneumonie caséeuse chez un nourrisson de 14 mois.

We report a case of caseous pneumonia in a 14-month-old HIV-negative infant. This clinical picture is usually observed in healthy young adults, rarely in infants. The clinical and radiological signs of caseous pneumonia often simulate acute non-tuberculous respiratory disease. Bacteriological confirmation is required, but the diagnosis can be suggested in case of a pulmonary syndrome with no bacterial isolate and unresponsive to well-conducted antibiotic therapy. The clinical course is rapid with caseous involution of the lung. Early diagnosis is required for specific curative treatment and to limit sequelae.