[Congenital toxoplasmosis: clinical and biological analysis of 11 cases in Tunisia]. / La toxoplasmose congénitale en Tunisie: analyse clinique et biologique de 11 cas.

Early diagnosis of congenital toxoplasmosis (CT) is necessary to prevent serious complications. The CT is diagnosed by the identification of the parasite in amniotic fluid during pregnancy or at birth by detection of antibodies synthesized by the fetus. The aim of this study was to determine the clinical and biological particularities of CT in a cohort of 11 cases observed in Tunisia and to evaluate the performance of the prenatal and neonatal diagnostic techniques that were used. In all patients, the presumed date of maternal contamination was determined based on the mother's serological data. Neonatal serological screening included assays for immunoglobulins (Ig) G and IgM by enzyme-linked-immuno-sorbent assay (ELISA), IgM by immuno-sorbent-agglutination-assay (ISAGA), and comparison of the mother-baby immunological profile by western blot IgG and IgM. Seven out of the 11 cases had been diagnosed prenatally; only 3 (43%) had a positive polymerase chain reaction (PCR) test. Ten newborns out of 11 had serological criteria of fetal infection; western blot results were positive in all of them, ISAGA was positive in 2 and ELISA in none. The newborn who had a negative serology had been treated in utero. The date of positivity of the western blot test varied: 6 cases at birth, 2 at 12 days of life and 2 at 1 month of life. The 2 patients who had positive ISAGA results had been contaminated during the 3rd trimester of gestation.

[Imported Schistosoma haematobium infection: report of 9 cases]. / La bilharziose urinaire: a propos de 9 cas importés.

BACKGROUND: Schistosomia haematobium infection has been eradicated from Tunisia since 1980. Only some imported cases are noted each year. AIM: The authors report nine cases of Schistosomia haematobium infection diagnosed. METHODS: The diagnosis was carried out within the framework of a survey carried out by the service of Pediatry of the hospital Mongi Slim of Tunis concerning 20 students of African extraction. RESULTS: Hematuria was found in all cases. Schistosomia haematobium infection is diagnosed in all patients by urinary parasitologic examination. Radiological evaluation had revealed mild uroradiologic abnormalities in five patients. All patients were treated by praziquantel. Remission was confirmed by urinary sterilization. Radiologic abnormilities persisted in 3 patients. CONCLUSION: Radiological evaluation and regular follow-up after treatment of students with Schistosomia haematobium infection is required.

[Cerebral hydatic cysts in children]. / Les kystes hydatiques cérébraux chez l'enfant.

BACKGROUND: Brain cysts caused by Echinococcus granulosus are rare; they occur during childhood in endemic areas. PATIENTS: Six children, aged to 8.5-years old (mean age: 5.5 years) were admitted from 1989 to 1994 because they suffered from progressive intracranial hypertension. The brain CT-scan showed typical features of supratentorial, unilocular (four cases) or multilocular (two cases) cysts. Three children had positive serological test; two had another cyst into their lung or liver and the third had generalized cysts. This last patient died post-operatively while the five others recovered after excision of cysts. CONCLUSION: Any progressive intracranial hypertension in endemic areas requires brain CT-scan that clearly identifies the cyst and its location.