Séroprévalence de la toxoplasmose chez les femmes enceintes au CHU Aristide Le Dantec de Dakar de 2011 à 2014

La toxoplasmose est une parasitose bénigne due à Toxoplasma gondii. Cependant, elle peut être sévère chez l'immunodéprimé ou chez le fœtus après une transmission congénitale. Toutefois ces complications peuvent être évitées par des moyens de prévention dont la clé repose sur la détermination de la sérologie toxoplasmique chez la femme enceinte. L'objectif de cette étude est de déterminer la séroprévalence de la toxoplasmose chez les femmes enceintes venues au laboratoire de parasitologie-mycologie du CHU Aristide Le Dantec de Dakar de 2011 à 2014. Un total de 341 femmes enceintes d'âge compris entre 19 et 49 ans avec une moyenne d'âge de 26 ans a été reçu au laboratoire pour un sérodiagnostic de la toxoplasmose. La technique immuno-enzymatique en phase solide (EIA) a été utilisée pour la détermination du titre en anticorps IgM et IgG. Une sérologie positive a été trouvée chez 157 femmes enceintes représentant une prévalence de 46,03%. Trois profils immunologiques ont été retrouvés : IgG+/IgM+, IgG-/IgM+ et IgG+/IgM-respectivement chez 12 femmes enceintes (3,52%), chez 18 femmes enceintes (4,98%) et chez 128 femmes enceintes (37,54%). Ceci justifie une amélioration du dépistage sérologique et de son suivi afin de prévenir les formes graves chez le fœtus et chez l'enfant

[Keratomycosis due to Fusarium oxysporum treated with the combination povidone iodine eye drops and oral fluconazole]. / Kératomycose à Fusarium oxysporum traitée par l'association de la povidone iodée en collyre et du fluconazole per os.

In developing countries where systemic antifungal are often unavailable, treatment of filamentous fungi infection as Fusarium is sometimes very difficult to treat. We report the case of a keratomycosis due to Fusarium oxysporum treated by povidone iodine eye drops and oral fluconazole. The diagnosis of abscess in the cornea was retained after ophthalmological examination for a 28-year-old man with no previous ophthalmological disease, addressed to the Ophthalmological clinic at the University Hospital Le Dantec in Dakar for a left painful red eye with decreased visual acuity lasting for 15 days. The patient did not receive any foreign body into the eye. Samples by corneal scraping were made for microbiological analysis and the patient was hospitalized and treated with a reinforced eye drops based treatment (ceftriaxone+gentamicin). The mycological diagnosis revealed the presence of a mold: F. oxysporum, which motivated the replacement of the initial treatment by eye drops containing iodized povidone solution at 1% because of the amphotericin B unavailability. Due to the threat of visual loss, oral fluconazole was added to the local treatment with eye drops povidone iodine. The outcome was favorable with a healing abscess and visual acuity amounted to 1/200th. Furthermore, we noted sequels such as pannus and pillowcase. The vulgarization of efficient topical antifungal in developing countries would be necessary to optimize fungal infection treatment.

[Nondermatophytic and noncandidal fungi isolated in Le Dantec University hospital of Dakar in 2014: Epidemiological, clinical and mycological study]. / Champignons non dermatophytiques et non candidosiques isolés au CHU Le Dantec de Dakar en 2014 : étude épidémiologique, clinique et mycologique.

In recent years, the incidence of superficial fungal infections involving nondermatophytic and noncandidal fungi increased considerably. The objective of this work was to analyze the epidemiological, clinical and mycological fungal infections due to nondermatophytic and noncandidal fungi diagnosed in the laboratory of parasitology-mycology of Le Dantec hospital in Dakar. With a retrospective study of the various cases of nondermatophytic and noncandidal fungi isolated in the laboratory of parasitology-mycology during the period of November 2013 to December 2014, we collected 22 cases of infections in 11 men and 11 women; age ranging from 17 to 75 years with a mean of 45.3 years (sex ratio=1): eight cases of intertrigo, seven cases of onychomycosis, four cases of palmoplantar keratoderma (KPP), a case of onychomycosis associated with interdigital intertrigo, a case of infectious myositis and one case of African histoplasmosis. We have isolated and identified a total of 22 nondermatophytic and noncandidal fungi: ten Fusarium, five Trichosporon, two Chrysosporium, two Geotrichum, one Rhodotorula, one Neoscytalidium dimidiatum and one Histoplasma capsulatum var. duboisii. So we are seeing the emergence of nondermatophytic and noncandidal increasingly isolated from superficial and local lesions. These fungi, generally contaminants or commensal, cause a problem regarding their direct involvement in pathological processes in which they are isolated. So we should respect the recommendations proposed for their involvement in pathological processes and, by a collaboration between clinician and biologist, demonstrate their real involvement through effective, targeted treatment.