Introduction: Gastrointestinal infections are one of the leading causes of morbidity and mortality throughout the world, particularly in the immunocompromised. Gastrointestinal PCR appears to be the technique of choice for establishing the molecular diagnosis of pathogenic gastrointestinal agents. The aim of this study was to establish the epidemiological, clinical and evolutionary profile of gastrointestinal infections and to study the impact of molecular diagnosis on the choice of a targeted therapy. Methods: This is a retrospective study carried out in the Microbiology Department of Arrazi Hospital of the Mohamed VI University Hospital Center, including all immunocompromised patients treated for a gastrointestinal infection and needing a hospitalization in the various departments, over a period of 15 months. Results: During the period studied, 124 patients were collected. The average age of the patients was 22 years. Signs of gastrointestinal infection were present in all patients. Of the patients sampled, 95.2% received probabilistic antibiotic therapy. Gastrointestinal infection has been documented in 57.26% of patients. A bacterial etiology was found in 76.81% of patients. A viral etiology was found in 13.04% of the patients and a parasitic etiology was found in 10.15% of the patients. Enteropathogenic E. coli was the most common infectious agent detected (19.53%). Co-infections were found in 29.84% of patients. Following PCR results, management was changed in 70 patients (56.45%), including initiation or modification of antibiotics in 40 patients (32.26%) and discontinuation of antibiotic therapy in 30 patients (24.19%). Conclusion: The diagnosis of gastrointestinal infections by multiplex PCR allowed us to provide optimal patient care with a reduction in the unnecessary use of antibiotics and an improvement in the course of care.
May 18, 2022
Dabska Tumor (Endovascular Papillary Angioendothelioma) of Orbit in a Middle Aged Male: A Case Report
Dr. Liz Maria Joseph, Dr. Sankar S
Page Numbers : 202-204
DOI : 10.36348/sjpm.2022.v07i05.003
The Dabska tumor also known as Endovascular papillary angioendothelioma is a rare, low-grade angiosarcoma that often affects the skin and subcutaneous tissues of children is characterized by intraluminal papillary endothelial structures. EPA has an overall favorable prognosis. The malignant potential of this tumor should not be ignored and close follow-up should be maintained.
May 14, 2022
An Unusual Oral Lichenoid Reaction to Potassium Alum: A Case Report and a Review of the Literature
Olagundoye Olufemi O, Usifo Usemen E, Ladeji Adeola M, Olajide Mofoluwaso, Ogbonna Chinedu D, Ndugbu Emeka
Page Numbers : 198-201
DOI : 10.36348/sjpm.2022.v07i05.002
Background: Potash alum mouth rinse has been well studied with appreciable success in protection against carious lesions and periodontal microbiota with no adverse reactions. While oral lichenoid reactions have been documented as complications of various dental materials and drugs none has been reported as a result of alum use. Case Description: An unusual oral lichenoid reaction to potash alum use in an adult patient who presented at the oral medicine and diagnosis clinic of the dental centre of the Lagos State University Teaching Hospital. He presented with complaints of excessive salivary flow and dark pigmentation of the palate, and a history of potash alum licking for more than a month. On examination a dark pigmentation involving the palatal gingiva related to 24-27, sialometry revealed normal salivary flow Hence a diagnosis of false sialorrhoea was made. The patient was referred to the Periodontology unit of the same institution where an excisional biopsy was carried out, this was diagnosed as a lichenoid reaction by the Oral Pathology unit. The patient was counselled to stop the use of alum and reassured about the normal salivary flow. The patient reported tremendous improvement on review. Conclusion: Many home remedy habits and practices can be harmful, this underscores the role of counseling patients against these unverified remedies.
May 7, 2022
Surinfection of the Renal Graft by a Strain of Klebsiella pneumonia Oxa 48 Producer and Therapeutic Impasse
H. Saffour, S. Rouhi, L. Darfaoui, A. Lamrani, N. Soraa
Page Numbers : 193-197
DOI : 10.36348/sjpm.2022.v07i05.001
The surinfection of the renal graft by multi-resistant germs constitutes a serious complication, which can engage the functional and vital prognosis in renal transplant patients. It is responsible for a problem of therapeutic management and of the benefit/risk ratio between antibiotic therapy at therapeutic doses and the contraindications linked to renal insufficiency and therapeutic impasse. This work reports the case of a kidney transplant recipient who died following complications of a superinfection of the graft by a strain of Klebsiella pneumoniae producing OXA 48. The purpose of this observation is to underline the nosocomial risk in kidney transplant patients and the difficulty of the therapeutic management of these multi-resistant infections.
Original Research Article
April 30, 2022
A Cross Sectional Study of Clinical and Histopathological Spectrum of Pediatric Brain Tumours
Introduction: Brain tumors are the most common tumor of the childhood and the second most common malignancies after haematological malignancies. Childhood central nervous system (CNS) tumors differ significantly from adult brain tumors in reference to their sites of origin, clinical presentation, tendency to disseminate early, histological features and their biological behaviour. Aims and Objective: Analyse the Clinical and histopathological spectrum of brain tumors, in pediatric patients ≤18 year of age. Materials and Method: This was a cross sectional study conducted at the department of pathology, SMS medical college, Jaipur from January 2020 to October 2021. This is a laboratory based descriptive type of observational study and data of brain tumors in children equal or less than 18 year of age procured and their clinico-histopathological spectrum were analyszed. Result: In our study, Out of 116 patients 51.8 % were male and 48.2 % were female. Mean age for the male cases were 10.11 and for female cases were 9.78. we observed intracranial pediatric tumors 67 cases (57.7%) were located in infratentorial region and 49 cases (43.3%) were located in supratentorial region and incidence for intracranial tumor was 39(33.62%) cases of astrocytomas followed by 25 (21.55%)cases of medulloblastoma, 20 (17.24%)cases of ependymoma, 13 (11.20%) cases of craniopharyngioma, 5 (4.31%) cases of pituitary adenoma, 4 (3.44%) cases of meningioma, 3 (2.58%) cases of embryonal and choroid plexus tumor, 2 (1.72%) cases of ganglioglioma and 1 (0.86%) case of Schwannoma and PNET. In this article, Based on tumor location, the symptoms of CNS tumors on the supratentorial region were headache (22 cases, 44.8%), impaired vision (10 cases, 20.4%), seizures (6 cases, 12.2%), vomiting (4 cases, 8.1%). Symptoms of CNS tumors on the infratentorial region were headache (48 cases, 71.6%), vomiting (5 cases, 7.4%), impaired vision (4 cases, 5.9%), seizures (3 cases, 4.4%). Conclusion: Infratentorial cases, maximum number of cases were medulloblastomas and supratentorial cases, maximum number of cases were astrocytic tumours. Overall astrocytic tumours in all senses constituted the most common group of CNS tumours. Within astrocytoma, low grade astrocytoma (grade I & II) was most common CNS paediatric tumour.
Original Research Article
April 29, 2022
Neonatal Septicemia: Clinical and Epidemiological Features
Rouhi S, Nachate S, Lamrani Hanchi A ,Bennaoui F, Slitine N, FMR Maouainine, Soraa N
Page Numbers : 180-185
DOI : 10.36348/sjpm.2022.v07i04.005
Introduction: to compare the clinical, biological, and evolutionary profiles of sepsis with multi-drug resistant and non-multi-drug resistant bacteria in the newborn population. Methods: we performed a prospective, observational, comparative study to monitor all the episodes of blood stream infection, received from the neonatal intensive care, from June to December 2019. Collected data included demographics, symptoms at the time of sepsis, laboratory values, microbiologic results, preliminary and final outcomes. Results: Out of 219 positive blood cultures, 93 episodes were retained. The median age was 6,66 days, 63.4% of newborns were male and 62,4% were premature, 39% of whom had a gestational age of less than 34 weeks. Multidrug-resistant (MDR) bacteria caused 68 sepsis episodes, while non-MDR resistant bacteria caused 25. Bacteremia with MDR organisms, in comparison with non-MDR organisms was associated with poorer preliminary outcomes after empirical antibiotherapy (14% vs 32%; P= 0,001), higher overall mortality rate (20% vs. 51%, P =0.003), and longer antibiotic intake (9.84 vs 7.56 ; P=0,02). The major risk factor found is prematurity (70% vs 40%, P<0,001), No statistical significance was found when other clinical features or laboratory values were compared for infections with MDR vs. non-MDR bacteria. Conclusion: Septicemia with MDR bacteria is more common than non-MDR one in NICU, and it is related to higher morbidity and mortality rates.
April 29, 2022
Primary Ovarian Lymphoma in Late Pregnancy: A Case Report
Dr. Amna Moulana, Dr. Mohamed El Tahmoudy, Dr. Riyazuddin Ansari, Dr. Bushra Ahmed Shaikh, Dr. Arjumand Moulana
Page Numbers : 177-179
DOI : 10.36348/sjpm.2022.v07i04.004
Involvement of the ovary with malignant lymphoma is a well-known late manifestation of disseminated nodal disease. Primary ovarian Burkitt lymphoma is very rare and mainly affects young children. We present a case of a 25-year old woman at 37 weeks pregnant with sporadic Burkitt lymphoma who presented as having ovarian cancer. The patient was managed via elective cesarean section and unilateral oophorectomy. Histopathological examination and immunohistochemical stains were carried out, revealing non-Hodgkin B-cell Burkitt lymphoma. After the diagnosis, the patient was referred to the oncology center for chemotherapy.