[Amebic brain abscess. Apropos of a case]. / Abcès cérébral amibien. A propos d'un cas.

We report a case of double primary amoebic brain abscess in a 22 year old man, with signs of intracranial hypertension and deficit. Computed tomography found two hypodense lesions, not suggestive of pyogenic abscesses. Aspiration of one of the two abscesses, revealed the organism, and the two abscesses regressed in response to medical treatment. The authors insist on the rarity of these abscesses, their gravity, and the difficulty of the diagnosis.

Sporadic cutaneous leishmaniasis in north Tunisia: identification of the causative agent as Leishmania infantum by the use of a diagnostic deoxyribonucleic acid probe.

A diagnostic kinetoplast deoxyribonucleic acid (DNA) probe has been used to identify as Leishmania infantum amastigotes taken from the lesions (in dermal fluid or lesion triturates) of 7 of 8 patients suffering from sporadic cutaneous leishmaniasis in north Tunisia. All 8 isolates were very difficult to culture but, subsequently, sufficient parasites of one isolate have been grown for isoenzyme typing, and were identified as zymodeme MON 24 of L. infantum. The advantages of using recombinant DNA probes for the identification of parasites from lesions are discussed.

[Staphylococcus aureus in the hospital milieu]. / Staphylococcus aureus en milieu hospitalier.

This study concern the distribution and sensibility towards some antibiotics of 318 Staphylococcus aureus strains isolated in bacteriological samples coming from la Rabta hospital units. The study of distribution shows that 75% of these strains are isolated in bacteriological samples coming from surgery and intensive care unit dermatology unit, and ear nose and throat unit. The bacteriological samples are matter, blood, and intensive care materials. The study of sensibility found a high frequency of methicillin resistant Staphylococcus aureus. These strains are also resistant towards macrolide and lincosamide. MLSB resistance is the predominant phenotypic aspect. It was also observed that all of Staphylococcus aureus gentamicin resistant strains were also resistant toward methicillin. At last is seems that pritinamicin, sulfamethoxazole-trimethoprim, and ofloxacin, are good alternatives for treatment of staphylococcus aureus infections diseases.

[Canine leishmaniasis in the region of Enfidha (Central Tunisia). Assessment of seroprevalence with direct agglutination (DAT) and indirect immunofluorescence (IFAT)]. / La leishmaniose canine dans la région d'Enfidha (Tunisie centrale). Estimation de la séro-prévalence par agglutination directe (DAT) et immunofluorescence indirecte (IFAT).

In order to assess canine leishmaniasis prevalence rate in Enfidha area, considered to be the most important kala-azar focus in Sousse Governorate, a serological survey was carried out in 6 localities. 265 sera were examined by DAT and IFAT. 16 (6.03%) showed positive results for anti-leishmania antibodies with significant variations according to the locality. A fairly DAT-IFAT good correlation was observed.

[Extension of the transmission area of kala-azar caused by Leishmania infantum (Nicolle 1908) to the center and south of Tunisia]. / Extension de l'aire de transmission du kala azar à Leishmania infantum (Nicolle 1908) vers le centre et le sud de la Tunisie.

Seventeen (17) parasitologically confirmed cases of infantile kala azar (KA) are reported from 1982 to 1991 in Tunisia, in areas (Gouvernorates of Sidi Bouzid, Kasserine, Sfax, Gafsa and Tozeur) where the disease has never (or exceptionally) been reported before. This tendency to the extension of the KA areas from Northern Tunisia to the Central and Southern parts could be explained by the ecological modifications that occurred in these zones following agriculture development programs that included an important increase of water resources (wells, dams etc...). These modifications probably contributed to the enhancement of the Leishmania infantum vector population densities making it possible for transmission cycles to be implemented and maintained in these areas; the parasite could have been brought with dogs from the North of the country.

[Conjunctival dirofilariasis, a case discovered in the Kairouan region]. / Dirofilariose sous conjonctivale à propos d'un cas découvert dans la région de Kairouan.

A case of conjunctival dirofilariasis was reported in a 55 years old patient, from Kairouan. The human dirofilariasis comes always and only from animals. In most cases, the dirofilariasis is localised under the skin; the ocular localisation of the disease is rare or exceptional. The authors discuss the epidemiology and describe the possible ocular localisation of the dirofilariasis.

Study of circulating immune complexes during the evolution of visceral Mediterranean leishmaniasis.

In the present study, sera of 56 children suffering from visceral Mediterranean leishmaniasis were analysed. The incidence of circulating immune complexes (CIC) by ELISA technique using the conglutinin binding assay was 39% before treatment, 28% after the first treatment, and nil at the end of the second one. The C4 levels remain low even after treatment. The anti-leishmania antibodies (AAL) account for 95% of the cases before treatment and 84% after treatment. The rheumatoid factor (FR) also remains with more or less the same frequency (74%) before and after treatment. The search for a correlation between the presence of CIC and the other immunological factors show that the average titre of AAL is higher in the group of patients that have CIC than in the group that does not. The C4 levels are significantly reduced in the CIC positive group of patients, whereas the rate of IgG is significantly increased in the same group. The study of the evolution of CIC under treatment in nine patients shows that they disappear at the end of the treatment, and that the FR reduces but does not disappear.