RESULTS:
1 - 20 of 21 for "Yassine Ben Lahlou"
Preprint: TIBIAL OSTEITIS CAUSED BY MYCOBACTERIUM TUBERCULOSIS A CASE REPORT
Tuberculosis is a major scourge posing a serious public health problem in countries where it is endemic. Osteoarticular involvement accounts for 3 to 5% of all tuberculosis cases and 10 to 15% of extrapulmonary tuberculosis cases. We report a case of tibial osteitis caused by Mycobacterium tuberculosis in a 52-year-old female patient who presented to the trauma department at the Mohammed V Military Teaching Hospital with a painful swelling of the lower part of her left leg. Standard X-rays and computed tomography (CT) scans revealed bone involvement specifically in the tibia. In an endemic context any persistent and atypical bone lesion should raise suspicion of osteoarticular tuberculosis to enable rapid diagnosis and appropriate therapeutic management. In the absence of other suggestive pulmonary or extrapulmonary lesions the diagnosis also relies on the exclusion of other pathologies such as malignant tumors which may present with similar clinical and radiological features.
Preprint: Pancreatic Tuberculosis Revealed by a Mass with Neoplastic Appearance: A Case Report
Introduction : Pancreatic tuberculosis is an extremely rare form of extrapulmonary tuberculosis. This condition can be challenging to diagnose due to its rarity nonspecific symptoms and radiological features that may mimic a neoplastic origin.
Case report: A 46-year-old immunocompetent patient with no past history of tuberculosis exposure presented with spontaneously resolving jaundice over the past month accompanied by non specific fever episodes and general fatigue with no other associated digestive symptoms. Abdominal CT and MRI scans revealed a poorly defined partially necrotic mass in the pancreatic head with heterogeneous hypodensity and enhancement after contrast injection. Additionally there were nodal and hilar macro-nodal lesions with necrotic appearances as well as peripancreatic lymphadenopathy. The patient was scheduled for an Endoscopic ultrasound (EUS) examination which revealed the presence of a heterogeneous lesion with areas of necrosis in the posterosuperior aspect of the head and isthmus of the pancreas accompanied by perilesional and celiac lymphadenopathies with necrotic centers. EUS-guided tissue sampling allowed the diagnosis of pancreatic tuberculosis with both histological examination and GeneXpert MTB/RIF testing rapidly positive for Mycobacterium tuberculosis followed by culture on solid Loewenstein-Jensen medium. The patient responded well to antitubercular chemotherapy.
Conclusion: Pancreatic tuberculosis though rare should be considered in cases of pancreatic masses especially in endemic regions. Tissue samples with necrosis should be tested for Mycobacterium tuberculosis using GeneXpert and Loewenstein-Jensen culture. This work highlights the GeneXpert MTB/RIF test as highly sensitive specific and fast making it ideal for diagnosing extra-pulmonary tuberculosis particularly when smear results are negative.
Preprint: Peribacillus simplex and Klebsiella pneumoniae Responsible for Pyonephrosis with Secondary Psoas Abscess: A Case Report
Bacterial urinary tract infections (UTIs) are common ranging from benign cystitis to complicated pyelonephritis which can lead to severe complications such as pyonephrosis and sepsis. Pyonephrosis characterized by the presence of pus in the renal cavities often requires urgent urological intervention. We report a unique case of pyonephrosis with a psoas abscess caused by Klebsiella pneumoniae (K. pneumoniae) and Peribacillus simplex (P. simplex) in a 64-year-old diabetic female patient. This is the first case of pyonephrosis caused by P. simplex. The patient presented with acute right lumbar pain fever and altered consciousness. Imaging revealed severe right hydronephrosis pyonephrosis and a perirenal phlegmon infiltrating the psoas with abscesses. Surgical drainage and nephrectomy were performed. Microbiological and proteomic analysis identified K. pneumoniae and P. simplex.This case highlights the importance of considering environmental bacteria like P. simplex in severe infections and ensuring rigorous protocols to avoid contamination. Successful management of pyonephrosis relies on prompt surgical drainage and appropriate antibiotic therapy based on culture results.
Preprint: First Moroccan Case of Infective Endocarditis Due to NDM-Type Carbapenemase-Producing Serratia marcescens in a Preterm Infant: A Case Report
Serratia marcescens (S. marcescens) is a Gram-negative rod-shaped bacterium belonging to the Enterobacteriaceae family commonly found in various environments. This opportunistic pathogen can cause urinary tract infections respiratory infections and septicemia but endocarditis is particularly rare and concerning due to its rapid and devastating progression. We report the second case in the world of infective endocarditis (IE) caused by S. marcescens in a preterm infant born at 34 weeks of gestation. The patient was a preterm male infant born at 34 weeks of gestation from a triplet pregnancy admitted to the neonatal intensive care unit on day 2 of life for respiratory distress. The mother aged 39 had undiagnosed gestational diabetes. Premature rupture of membranes had occurred 10 days before delivery necessitating prophylactic treatment with amoxicillin. On day 4 of life the newborn developed a fever with elevated CRP levels and leukocytosis leading to antibiotic therapy with colistin imipenem and amikacin. Blood cultures revealed the presence of carbapenemase-producing S. marcescens sensitive to fluoroquinolones. A cardiac ultrasound showed vegetations on the mitral valve confirming the diagnosis of IE. Despite intensive treatment the newborn died on day 16 of life due to septic shock. This rare case of endocarditis caused by S. marcescens highlights the severity of this infection in preterm infants. Treatment relies on appropriate antibiotic therapy. Prevention requires strict hygiene measures. Further research is needed to establish optimal therapeutic recommendations.
Preprint: Bacteriological profile of community peritonitis operated in a Moroccan Hospital
Introduction. Peritonitis is characterized by acute inflammation of the peritoneum often resulting from digestive organ perforation or intra-abdominal septic focus. It may be either of infectious or noninfectious origin. The germs involved are those of the digestive flora (Enterobacteriaceae and Anaerobic) while gram-positive cocci and yeasts can be isolated in nosocomial infections. Our study aims to isolate and identify the germs involved in community-acquired peritonitis in order to assess their susceptibility to the antibiotics available in our Country.
Methods. This is a retrospective study of bacteriological profile of community peritonitis in Rabat Morocco. A total of 150 adult patients with peritonitis were admitted and samples were collected intraoperatively for bacteriological examination between July 1 2022 and April 30 2023.
Results. Among the 150 patients 101 (67.8%) were males and 48 (32.2%) were females with sex/ratio of 2.1. The mean age of the patients was 40.5 years +/- 20.12. The distribution of germs was dominated by Escherichia coli (44%). Overall 70% of Escherichia coli isolated had a resistance to Ampicillin but no resistance to Ampicillin has been reported by Enterococcus.
Discussion. In the present study we were interested in the bacteriological profile of community peritonitis in order to adapt the antibiotic therapy to our bacterial ecology. Our findings indicate a concerning trend of increasing resistance among Escherichia coli to the commonly used Amoxicillin/Clavulanic Acid combination in our clinical setting.
Conclusion. Consequently there is a need to reassess the empiric antibiotic prescribed for the management of community-acquired peritonitis.
Preprint: Cutaneous tuberculosis an unusual localization: A case report
Tuberculosis is a major public health problem worldwide. In Morocco tuberculosis is still endemic with almost 30000 cases notified annually.
The distribution of tuberculosis cases according to localization shows a significant percentage of extra- pulmonary tuberculosis (43%) compared with 57% for Pulmonary tuberculosis.
Cutaneous tuberculosis is an exceptional extra-pulmonary form of the disease with an incidence of 0.5% to 2% of cases. Given that the clinical symptoms of cutaneous tuberculosis are variable and nonspecific diagnosis is not always easy.
We report a rare case of cutaneous tuberculosis in a patient with a history of pulmonary and cutaneous sarcoidosis.
Preprint: Primary iliac bone tuberculosis: A case report
Tuberculosis is an infectious disease caused by the Mycobacterium tuberculosis complex. It is a major public health problem and one of the world's leading causes of morbidity and mortality. It occurs in both pulmonary and extra-pulmonary forms the pulmonary form being the most common. Primary iliac bone tuberculosis remains a rare clinical entity even in endemic areas. Its diagnosis can be challenging due to its similarity to other bone conditions. We report a rare case of primary iliac bone tuberculosis in a 63-year-old patient on peritoneal dialysis with the following medical history: hypertension type II diabetes complicated by diabetic retinopathy and diabetic kidney disease. Recent advances in molecular biology in particular with the advent of the Genexpert® have considerably improved patient management providing microbiological evidence in less than two hours.
Preprint: A hydrocele revealing epididymal tuberculosis
Urogenital tuberculosis is a severe form of extrapulmonary tuberculosis. The organs most commonly affected are the epididymis and the testis. Clinical manifestations may include epididymitis orchi-epididymitis hydrocele associated with leukocyturia and significant hematuria. We report a case of a patient with a hydrocele that revealed epididymal tuberculosis.
Preprint: Exceptional association of two species of bacteria causing acute appendicitis: Haemophilus influenzae and Enterobacter cloacae
Appendicitis typically caused by appendiceal lumen obstruction is a prevalent abdominal surgical emergency worldwide. While most cases involve Enterobacterales Haemophilus influenzae primarily known for upper respiratory infections is infrequently associated with gastrointestinal infections. This article presents an exceptional case of acute appendicitis caused by both Haemophilus influenza and Enterobacter cloacae in a 15-year-old child highlighting the significance of recognizing uncommon pathogens in appendicitis and emphasizing the necessity for thorough microbiological investigations to refine diagnostic approaches.
Preprint: Invasive Streptococcus pyogenes Infection: A case report
The Group A Streptococcus also known as Streptococcus pyogenes is a human pathogen causing various infections ranging from mild such as tonsillitis and impetigo to severe and invasive conditions like septicemia and necrotizing fasciitis. Despite a decline in incidence and severity during the 20th century due to antibiotics there has been a reported increase in severe cases since the 1980s in industrialized countries.
Streptococcus pyogenes (S. pyogenes) is a human pathogen with a natural reservoir in the 26 pharynx and skin exhibits asymptomatic carriage in various body sites. It is responsible for a 27 spectrum of clinical manifestations from asymptomatic carriage to severe invasive infections. 28 Transmission occurs through respiratory droplets or direct contact with skin lesions. 29 Bacteriologically S. pyogenes is a gram-positive β-hemolytic streptococcus. This summary highlights a case of invasive Group A Streptococcus infection in a 28-year-old diagnosed at the microbiology laboratory of the Mohammed V Military Training Hospital in Rabat Morocco.
A 28-year-old patient with a history of chickenpox presented with acute febrile oligoarthritis. Following a recent flu-like syndrome and febrile tonsillitis the patient experienced asymmetric inflammatory oligoarthralgia affecting the left knee left ankle and right shoulder accompanied by functional impairment of the left lower limb. Upon admission clinical examination revealed swelling positive patellar tap and sternal involvement. Laboratory and imaging findings indicated an abscessed collection in the left knee and anterior mediastinitis. Emergency aspirations revealed Group A Streptococcus specifically Streptococcus pyogenes leading to a diagnosis of septic arthritis. Dual antibiotic therapy and knee joint drainage resulted in symptom resolution after 45 days.
The rise in severe Group A Streptococcus infection underscores the need for early detection and treatment. Widely sharing the French High Council for Public Health’s antibiotic prophylaxis recommendations is crucial for awareness. Collaborating between clinicians and microbiologists is essential for effective management.
Preprint: Peritoneal Tuberculosis, an underestimated diagnosis: A case report
Tuberculosis is an infectious disease that most often affects the lungs it is of human-to-human transmission caused by Mycobacterium tuberculosis.
Peritoneal tuberculosis is an extra-pulmonary form of the disease that usually manifests as an ascitic syndrome with or without fever in a context of altered general condition often in endemic areas. The diagnosis of peritoneal tuberculosis is not always easy as the clinical signs are often insidious and unspecific.
We report a case of peritoneal tuberculosis in an 18-year-old young female who had presented for 10 days with a progressive increase in abdominal volume associated with vomiting and diarrhea.
Preprint: Clinical Value of Procalcitonin as a Biomarker for Detecting a Primary Tuberculous Spinal Infection: Case Report and Review of the Literature.
Procalcitonin is a biomarker potentially useful in the diagnosis of sepsis and severe bacterial infections. Few studies have examined the usefulness of this biological marker in the diagnosis of tuberculous spondylodiscitis. We report the case of a 37-year-old woman with an unremarkable medical history who was newly diagnosed with tuberculous spondylodiscitis while the procalcitonin test was negative. This case confirms the hypothesis that procalcitonin is not a useful parameter to support the diagnosis of primary tuberculous spondylodiscitis.
Preprint: Osteoarticular tuberculosis of the ankle, a rare localization: a case report
Tuberculosis is a real scourge posing a real public health problem in countries where the disease is endemic. Osteoarticular tuberculosis represents 3% to 5% of all tuberculosis cases and 10% to 15% of extra-pulmonary tuberculosis cases. Involvement of the foot and ankle is rarer. We report the case of osteoarticular tuberculosis of the ankle in a 71-year-old patient with type 2 diabetes and hypertension who presented to the trauma department of the Mohammed V Military Hospital with a painful swelling of the ankle. Standard X-rays and CT scan of the ankle showed inflammatory involvement of the bone and joints. Antitubercular therapy was instituted. Given the context of endemicity any atypical presentation of lingering bone lesions should raise the suspicion of an osteoarticular tuberculosis in order to ensure early therapeutic management.