[Parietal tuberculosis complicated by pulmonary embolism]. / Tuberculose pariétale compliquée d'embolie pulmonaire.

Tuberculosis is a frequent infectious disease in developing countries. It can affect the lung or spread to other parts of the body. Extra-pulmonary tuberculosis poses a major diagnostic problem. We report the case of a patient with pulmonary embolism revealing parietal tuberculosis. This study emphasizes the importance of etiologic assessment in patients with pulmonary embolism.

Dilatations des bronches révélant une mucoviscidose chez un adulte

La dilatation des bronches est une maladie d'étiologies diverses. La mucoviscidose est l'une des causes de cette pathologie. Cette cause congénitale est la plus fréquente en occident mais rare dans la population non caucasienne. Observation : Nous rapportons l'observation d'une patiente âgée de 25 ans, célibataire, diabétique type 1, bronchorrhéique chronique depuis 8ans, hospitalisée pour bilan étiologique de dilatation des bronches diffuses avec un hippocratisme digital. L'indice de masse corporelle était à 11,53kg/m2. Le test de la sueur était positif à deux reprises (86 mmol/l, 94 mmol/l). La tomodensitométrie du thorax objectivait l'image de dilatation des bronches prédominantes aux lobes supérieures. La tomodensitométrie des sinus montrait une sinusite maxillaire. La patiente était mise sous bi-antibiothérapie, sous oxygénothérapie et une ventilation non invasive. L'évolution était favorable.Conclusion: A travers cette observation, le diagnostic de la mucoviscidose n'est pas aisé dans la population non caucasienne. Malgré l'âge des patients, il faut y penser à la mucoviscidose comme étiologie de dilatation des bronches

[Diffuse and calcified nodular opacities]. / Opacités nodulaires diffuses et calcifiées.

Pulmonary adenocarcinoma is difficult to identify right away with respect to anamnestic and even to radiological data. We here report the case of a woman with dyspnea. Radiological examination showed disseminated micronodular opacity confluent in both lung fields with calcifications in certain locations. Histological examination of transbronchial biopsies allowed the diagnosis. The prognosis was poor with the death of the patient.

[Pulmonary tuberculosis among hospitalized patients in Brazzaville: impact of late diagnosis of HIV infection on radiographic abnormalities]. / Tuberculose pulmonaire à Brazzaville en hospitalisation pneumologique: impact du diagnostic tardif à l'infection au VIH sur les anomalies radiographiques.

The aim was to describing the different radiographic features of pulmonary tuberculosis according to the degree of immunosuppression in HIV patients. We report a retrospective study of 80 untreated HIV-positive patients with pulmonary tuberculosis hospitalized in the Pneumo-Phthisiology Department in Brazzaville from January 2013 to January 2014. Our sample consisted of 44 women (55%) and 36 men (45%), the sex ratio was 0.81. The average age was 37.5 ± 9.17 years, the average CD4 count was 153.13 ± 86,6 cell/mm3. Sputum smear microscopy to detect acid-fast bacilli was positive in 75% of patients with CD4 cell count >200 cell/mm3. Mediastinal adenopathies, middle and lower lung field involvement and miliary were more frequent in patients with CD4 cell count < 200 cell/mm3. Severe immunosuppression is significantly associated with atypical radiographic presentation of tuberculosis.

[Localised bronchiectasis revealing carcinoid tumor]. / Dilatation de bronches localisée révélant une tumeur carcinoïde.

We here report the case of a 32-year old female patient with a 5-year history of recurrent purulent bronchial syndrome. Radiological assessment showed a left basithoracic finely ringed bright areas related to cylindrical bronchiectasis located in the left lower lobe. Flexible bronchoscopy showed smooth surface, reddish tumor obstructing the entrance of the left basal pyramid. The patient underwent left lower lobectomy associated with mediastinal lymph node dissection. Histological examination of the surgical specimen was in favor of typical carcinoid tumor. Postoperative outcome was uncomplicated and clinical and radiological evolution was good.

Syndrome de Kartagener révélé à l'âge adulte

Le syndrome de Kartagener est une maladie génétique qui se caractérise par une association de situs inversus, de polypose naso-sinusienne et dilatation des bronches. Ce syndrome est découvert le plus souvent dans l'enfance, mais aussi à l'âge adulte. Nous rapportons une observation médicale d'une patiente atteinte de ce syndrome révélé à l'âge adulte suite à la recherche étiologique des dilatations des bronches. A travers cette observation les auteurs soulignent la rareté de ce syndrome comme cause de dilatation des bronches dans leurs pratiques quotidiennes

Bronchiectasis: a bacteriological profile.

The occurrence of bronchiectasis can involve a combination of many environmental factors, including infection. The aim of our work is to determine the bacteriological profile of bronchiectasis. This is a retrospective study of 100 patients hospitalized in between January 2010 and July 2013. The average age was 48 years with a 58% female predominance. Symptomatology was by a bronchial syndrome in 90% of cases. Bacteriological examination was able to isolate the microbe in 35% of cases. In our study it was through the examination of sputum cytology in 27% of cases, through the examination of liquid bronchial aspiration in 5% of cases, and through direct examination of sputum in search of Mycobacterium tuberculosis in 3% of cases. Microbes isolated were: Streptococcus pneumonia in 11 cases; Pseudomonas aeruginosa in 10 cases, Klebsiella pneumonia and Mycobacterium tuberculosis in 3 cases each; Moraxella catarrhalis, Haemophilus influenzae, Escherichia coli, Citrobacter spp, Serratia marcescens, Mycoplasma pneumoniae, Acinetobacter baumannii and Staphylococcus aureus in one case each. Through this work, the authors highlight that Streptococcus pneumoniae and Pseudomonas aeruginosa are the most commonly- identified microbes in their patients. It is necessary to have a full bacterial examination and to repeat it regularly over the course of the bronchiectasis.