What is the nutritional status of your patients suffering from strokes.

Strokes can significantly affect the autonomy and the ability of the patient to feed properly. Malnutrition after strokes increases the length of stay in hospital, increases mortality and aggravates disability. Nutritional support is a therapeutic that can be useful in the management of strokes and during the rehabilitation period. It may help to reduce the occurrence of complications due to the physical dependence associated with this condition. The objective of our study was to evaluate, through a questionnaire, the opinion of prescribing doctors working in the Department of Neurology of The FANN National Teaching Hospital in Dakar. The interest of the question resides in the fact that the Center does not have a dedicated nutritionist for inpatients. This was an opinion poll about their concerns about the nutritional status of patients in the therapeutic projects they propose during the stroke. The type of the chosen opinion poll was elementary, type random. The questionnaire was individual and consisted of five items of single-response and multiple-choice questions. The results of this study reveal that while the nutritional status of patients with limited autonomy in the service was a concern in the intentions of the prescribers, in practice it was not taken into account in therapeutic projects. To date, no structured protocol is available in cases of proven nutritional deterioration in patients. Nutritional management must be integrated into the overall management of Neurology patients, particularly in elderly victims of strokes.

On-farm Campylobacter and Escherichia coli in commercial broiler chickens: Re-used bedding does not influence Campylobacter emergence and levels across sequential farming cycles.

Limitations in quality bedding material have resulted in the growing need to re-use litter during broiler farming in some countries, which can be of concern from a food-safety perspective. The aim of this study was to compare the Campylobacter levels in ceca and litter across three litter treatments under commercial farming conditions. The litter treatments were (a) the use of new litter after each farming cycle; (b) an Australian partial litter re-use practice; and (c) a full litter re-use practice. The study was carried out on two farms over two years (Farm 1, from 2009-2010 and Farm 2, from 2010-2011), across three sheds (35,000 to 40,000 chickens/shed) on each farm, adopting three different litter treatments across six commercial cycles. A random sampling design was adopted to test litter and ceca for Campylobacter and Escherichia coli, prior to commercial first thin-out and final pick-up. Campylobacter levels varied little across litter practices and farming cycles on each farm and were in the range of log 8.0-9.0 CFU/g in ceca and log 4.0-6.0 MPN/g for litter. Similarly the E. coli in ceca were ∼log 7.0 CFU/g. At first thin-out and final pick-up, the statistical analysis for both litter and ceca showed that the three-way interaction (treatments by farms by times) was highly significant (P<0.01), indicating that the patterns of Campylobacter emergence/presence across time vary between the farms, cycles and pickups. The emergence and levels of both organisms were not influenced by litter treatments across the six farming cycles on both farms. Either C. jejuni or C. coli could be the dominant species across litter and ceca, and this phenomenon could not be attributed to specific litter treatments. Irrespective of the litter treatments in place, cycle 2 on Farm 2 remained Campylobacter-free. These outcomes suggest that litter treatments did not directly influence the time of emergence and levels of Campylobacter and E. coli during commercial farming.

Breast cancer risk after radiotherapy for heritable and non-heritable retinoblastoma: a US-UK study.

BACKGROUND: Retinoblastoma is a rare childhood eye cancer caused by germline or somatic mutations in the RB1 gene. Previous studies observed elevated breast cancer risk among retinoblastoma survivors. However, there has been no research on breast cancer risk in relation to radiation (primarily scatter radiation from the primary treatment) and genetic susceptibility of retinoblastoma survivors. METHODS: Two groups of retinoblastoma survivors from the US and UK were selected, and breast cancer risk analysed using a case-control methodology, nesting within the respective cohorts, matching on heritability (that is to say, having bilateral retinoblastoma or being unilateral cases with at least one relative with retinoblastoma), and using exact statistical methods. There were a total of 31 cases and 77 controls. RESULTS: Overall there was no significant variation of breast cancer risk with dose (P>0.5). However, there was a pronounced and significant (P=0.047) increase in the risk of breast cancer with increasing radiation dose for non-heritable retinoblastoma patients and a slight and borderline significant (P=0.072) decrease in risk of breast cancer with increasing radiation dose for heritable retinoblastoma patients, implying significant (P=0.024) heterogeneity in radiation risk between the heritable and non-heritable retinoblastoma groups; this was unaffected by the blindness status. There was no significant effect of any type of alkylating-agent chemotherapy on breast cancer risk (P>0.5). CONCLUSIONS: There is significant radiation-related risk of breast cancer for non-heritable retinoblastoma survivors but no excess risk for heritable retinoblastoma survivors, and no significant risk overall. However, these results are based on very small numbers of cases; therefore, they must be interpreted with caution.

[Comparative prognosis of pulmonary embolism in patients infected with COVID-19 and patients not infected with COVID-19 in Ouagadougou]. / Pronostic comparé de l'embolie pulmonaire chez les patients infectés au COVID-19 et les patients non infectés au COVID-19 à Ouagadougou.

OBJECTIVE: the study's objective was to determine impact of COVID-19 on the prognosis of pulmonary embolism. PATIENTS AND METHODS: An analytical multicenter cross-sectional study with retrospective data collection was carried out in three university hospitals and a private clinic in Ouagadougou from March, 2020 to July 2021. It included consecutive patients hospitalized for PE confirmed on chest CT angiography or by the association an acute cor pulmonale on echocardiography-Doppler with deep vein thrombosis on venous ultrasound-Doppler of the lower limbs and having carried out a COVID-19 test (RT-PCR or rapid diagnostic test). Control cases consisted of all COVID-19 negative PE cases. Data comparison was carried out using the Epi info 7 software. A univariate then multivariate analysis allowed the comparison of the prognosis of the two subpopulations. The significance level retained was p < 0.05. RESULTS: 96 patients with COVID-19+ and 70 COVID-19- PE were included. The prevalence of PE in patients hospitalized for COVID-19 was 7.05%. The average patient age was 61.5±17 years for COVID-19+ patients and 49.6±15.9 years for COVID-19- patients. Pulmonary condensation syndrome (p=0.007), desaturation (p=0.0003) and respiratory distress syndrome (p=0.006) were more common in COVID-19+ patients. The hospital death rate was 27.1% in COVID-19+ patients and 10% in COVID-19- patients (p=0.0024). Age > 65 years and COVID-19 pneumonia were the independent factors of death. CONCLUSION: COVID-19 is associated with clinical severity and excess mortality in patients with pulmonary embolism.

Yellow luminescence of gallium nitride generated by carbon defect complexes.

We demonstrate that yellow luminescence often observed in both carbon-doped and pristine GaN is the result of electronic transitions via the C(N)-O(N) complex. In contrast to common isolated defects, the C(N)-O(N) complex is energetically favorable, and its calculated optical properties, such as absorption and emission energies, a zero phonon line, and the thermodynamic transition level, all show excellent agreement with measured luminescence data. Thus, by combining hybrid density functional theory and experimental measurements, we propose a solution to a long-standing problem of the GaN yellow luminescence.

Atypical manifestation of a fistula between a hydatid cyst of a liver and a gallbladder: A case report.

The hydatid cyst of the liver is the most common location of hydatid disease. Complications in this form are dominated by superinfection of the cyst and rupture into the bile ducts or the peritoneal cavity. We report the case of a 54-year-old female patient with a hydatid cyst of the liver complicated by a rupture in the gallbladder revealed by urinary symptoms.

Cherubism: a rare case report with literature review.

Cherubism is an autosomal dominant disorder caused by a mutation of the gene encoding the binding protein SH3BP2. However, non-hereditary forms are observed, probably related to a de novo mutation. It is clinically manifested by an enlargement or a deformation of the jaw associated with a malposition of the teeth. In severe forms, these deformations can have a psychological impact, associated with ocular complications, as well as a reduction of the pharynx lumen and phonation disorders. The appearance of the lesions on imaging is not very specific, however it remains essential for the mapping of the lesions. We report a case of cherubism in a 12-year-old boy with no family history. This case report's objective is to identify the radiological aspect of this pathology and establish an early diagnosis to oriented therapeutic interventions.

[Adult-onset Still's disease: case report in Dakar, Senegal]. / Maladie de Still de l'adulte: une observation à Dakar (Sénégal).

Adult-onset Still's disease is a uncommon form of inflammatory rheumatism. It has rarely been reported in black Africa. The purpose of this report is to describe a case in a 49-year-old woman from Dakar, Senegal.

[Metabolic disorders and cardiovascular risk factors observed in patients infected by the HIV with antiretroviral therapy in Burkina Faso]. / Troubles métaboliques et facteurs de risques cardiovasculaires chez les patients infectés par le VIH sous antirétroviraux au Burkina-Faso.

The purpose of this descriptive transverse study is to describe metabolic disorders and cardiovascular risk factors in HIV-infected patients undergoing antiretroviral therapy in the day-care unit of the University Hospital of Ouagadougou, Burkina-Faso. A total of 100 patients (Burkinavi cohort) undergoing antiretroviral therapy with a minimum of 42-months of follow-up (October 2005 to Mars 2009) were included. There were 77 females and 33 males with a mean age of 37 years. Most patients, i.e., 95%, were positive for HIV1. Mean body mass index was 22 kg/m2. Mean CD4 count was 280/mm3. Viral load was undetectable in 66 of the 71 patients who underwent viral load testing. Retroviral therapy consisted of the TriomuneR combination (Stavudine + lamivudine + névirapine) at a fixed dose in 27 cases. Cardiovascular risk factors included family history of high arterial blood pressure in 5 patients, smoking in 4, and obesity in 8. During follow-up, seven patients presented hypertension. Metabolic disorders included hyperglycemia (4%), hypertriglyceridemia (17%) and hypercholesterolemia (14%). Lipodystrophia was noted for 6 patients. Despite the short follow-up period, metabolic disorders and cardiovascular risk factors were observed at our patients under antiretroviral therapy.

[Abdominal actinomycosis mimicking an abdominal tumor. Case report in Senegal]. / Actinomycose abdominale tumorale. Une observation au Sénégal.

The purpose of this report is to describe a case of abdominal actinomycosis (Actinomyces israelii) with a pseudo-tumoral appearance in a 57-year-old Senegalese woman.

[Evolution of Uterine Ruptures at the Maternity of Ignace Deen National Hospital (Chu of Conakry)]. / Évolution des Ruptures Utérines à la Maternité de L'hôpital National Ignace Deen (Chu de Conakry).

Uterine rupture is a common obstetrical drama in our delivery rooms that has become exceptional in developed countries. In developing countries including Guinea, this tragedy is one of the major concerns of the obstetrician. The objectives of this work were: to evaluate the frequency of uterine rupture in the department, to describe the socio-demographic and clinical characteristics of the patients, to identify the factors favoring the occurrence of uterine rupture, to evaluate the maternal-fetal prognosis and propose a prevention strategy to reduce maternal and fetal morbidity and mortality by uterine rupture. This was a descriptive study with data collection in two phases, one retrospective lasting 18 months from July 1, 2017 to December 31, 2018 and the other prospective, lasting 18 months also from January 1, 2019 to June 30, 2020 both carried out at the maternity ward of the Ignace Deen National Hospital. We collected 84 cases of uterine rupture out of 18,790 deliveries, i.e. a frequency of 0.44%. During the same time 10,067 cesarean sections were realized, i.e. one laparotomy for uterine rupture for 120 cesarean sections. The average age of the patients was 28.14 years with a standard deviation of 2 years and the average profile is that of a housewife (51.8%), multiparous (44.6%), evacuated from peripheral maternity (85.5%) and having an insufficient number of antenatal consultations (82.6%). In 93.1% of cases, the uterine rupture had occurred in delivery centers, peripheral maternity hospitals and on the way, the uterine ruptures were mostly spontaneous (65.1%), and occurred in a healthy uterus (59.0%). Uterine rupture was more frequently complete (83.33%). Surgical treatment was more frequently conservative with hysterorrhaphy (88.1%). We recorded 12 maternal deaths, i.e. a case fatality rate of 14.6%. On admission, almost all of the women showed no signs of fetal life. To reduce the frequency of uterine ruptures, better organization of emergency obstetric and neonatal care and better screening for risk factors for obstructed labor during prenatal consultations should be encouraged.

[Socio-Anthropological Determinants of the High Prevalence of Obstetric Fistula in Guinea]. / Déterminants Socio-Anthropologiques de la Prévalence Élevée des Fistules Obstétricales en Guinée.

Objective: The purpose of this study was to analyse the socio-anthropological determinants (representations, beliefs, practices and perceptions of health services) of the high prevalence of obstetric fistulas in Guinea. Patients and methods: From January 15 to February 15, 2018, we carried out a qualitative study in three health centres (one urban and two rural). The study focused on biological mothers who attended the centres to get vaccinated their children. The data were collected by semi-structured individual interview. Results: None of the 42 respondents could link the occurrence of obstetric fistulas and obstructed labour. Participants at all three study sites believed that obstructed labour and obstetric fistula have a mystical origin. In Kissidougou, the respondents thought that obstructed labour and obstetric fistulas are caused either by soubaya, sorcery in Malinké or the evil spell korte in Malinké cast by an enemy, or the bad behaviour of the parturient which means either she practices adultery or if she behaves disrespectfully towards elders. In Dubréka, the respondents linked the occurrence of labour dystocia and obstetric fistula to witchcraft koromikhi in Sousou. In Labé, some respondents thought that obstructed labour and obstetric fistula are due to divine punishment in local dialect lette Allah when the woman does not respect her husband or has contracted the pregnancy out of the legal union. Others deemed that childbirth is difficult because of the narrowness of the delivery route in Fulani lawol ngol no faadhi in parturients who do not have sex during pregnancy or when the woman had not adequately had female circumcision, in local dialect o suuwaaki laabhi which means, part of the clitoris was left in place during the excision. The majority of respondents had a poor perception of health services (male staff, lack of privacy, poor hygiene, abuse). Several cultural practices (early wedlocks, genital mutilations, dietary restrictions, home deliveries) also induce obstetric fistulas. Conclusion: Respondents' cultural beliefs and practices regarding childbirth limit women's attendance at maternity hospitals during childbirth and favour obstetric fistulas.

Heterogeneity and penetration of HIV-1 non-subtype B viruses in an Italian province: public health implications.

This study assessed changes in prevalence and distribution of HIV-1 non-subtype B viruses in Italian and immigrant patients over two decades in a province in Italy. All HIV-positive patients who underwent genotypic resistance testing were selected. Prevalence of non-subtype B viruses in 3-year periods was calculated. All sequences of non-subtype B and those provided by REGA as unassigned were analysed for phylogenetic relationships. In total, 250/1563 (16%) individuals were infected with a non-subtype B virus. Prevalence increased over time, reaching a peak (31.5%) in 2004-2006. In Italian patients, the most frequent subtypes were B (92.5%) and F1 (4%). F1 subtype was also prevalent in patients from South America (13.6%); in patients of African origin, CRF02_AG (54.9%) and G (12.3%) were the most frequent. HIV-1 non-subtype B infections in Italians were mostly found in patients who acquired HIV sexually. A phylogenetic relationship between F subtypes in Italian and representative HIV-1 sequences from Brazil was found. C subtypes in Italians were phylogenetically related to subtypes circulating in Brazil. Inter-subtype recombinants were also found in the latest years. The HIV-1 epidemic in Brescia province evolved to the point where about 1/3 patients recently diagnosed harboured non-B HIV subtypes. The distribution of HIV-1 non-B subtypes in Italian patients resembled that in South American patients and phylogenetic relatedness between some Italian and South American HIV-1 strains was found. The possible epidemiological link between these two populations would have been missed by looking only at risk factors for HIV acquisition declared by patients. The evidence of inter-subtype recombinants points to significant genetic assortment. Overall our results support phylogenetic analysis as a tool for epidemiological investigation in order to guide targeted prevention strategies.

Detection and quantitation of gallid herpesvirus 1 in avian samples by 5' Taq nuclease assay utilizing Minor Groove Binder technology.

A 5' Taq nuclease assay utilizing Minor Groove Binder technology and targeting the thymidine kinase gene of gallid herpesvirus 1 (GaHV-1) was designed and optimized for use in diagnosing avian infectious laryngotracheitis. The assay was specific for GaHV-1 in that it did not react with other avian viral or bacterial pathogens. The detection limit was 1.0x10(-2) median tissue culture infectious dose per reaction or 90 target copies per reaction. Fifteen out of 41 diagnostic samples from sick birds reacted in the assay, five of which produced a typical alphaherpesvirus cytopathic effect (CPE) on chicken kidney (CK) cells. Sequencing, using amplicons generated by a polymerase chain reaction with primers flanking the 5' Taq nuclease amplicon, confirmed the presence of GaHV-1 in six samples (two producing alphaherpesvirus CPE on CK cells, three not producing alphaherpesvirus CPE, and one that was not inoculated onto CK cells). Tracheal swabs taken from 18 healthy broilers did not react in the assay. The ability of the assay to determine viral load in samples was demonstrated. Overall the assay is suitable for the rapid diagnosis of infectious laryngotracheitis.

[Dermatomyositis and polymyositis: 21 cases in Senegal]. / Dermatomyosites et polymyosites: 21 cas au Sénégal.

Dermatopolymyositis (DPM) is a term describing a group of disorders comprising multiple distinct entities depending on interactions between genetic and environmental factor. There is a paucity of studies on DPM in black Africa. The purpose of this report is to describe epidemiological, clinical, laboratory and therapeutic aspects of dermatomyositis (DM) and polymyositis (PM) observed at the Principal Hospital in Dakar, Senegal. A retrospective review as conducted of patients hospitalized for DM and PM in Medical Departments of Principal Hospital. Diagnosis of DRM was based on the criteria of Bohan and Peter's in all cases. A series of 21 black African patients was compiled including 15 with DM and 6 with PM. Mean age was 52 years and the M/F sex ratio was 0.6. The mean delay for diagnosis was 6 weeks (range, 3 to 12 weeks). Initial signs were dermatological in 12 patients, pulmonary in one and muscular in the remaining cases. The most common dermatological sign was erythema characterized by a zebra-like aspect on the extended limbs. Erythema was frequently pruriginous with a flagellate aspect on the back. Muscular signs were observed in 18 patients and included pharyngeal manifestations in 10 patients. Amyopathic DM was not observed. Cardiac abnormalities included tachycardia (4 cases), AVB (1), ischemic lesion (1), relaxation disturbances (4), pericardial effusion (3), myocarditis (2) and pulmonary hypertension (1). The most common pulmonary manifestation was interstitial lung disease observed in 6 patients. Gastrointestinal signs were noted in 9 patients including endoscopic evidence of superficial erosion in 4 cases. Electromyography (EMG) tracings revealed myogenic disease in 14 cases including 2 associated with reduced peripheral nervous conduction speed. Severe lymphopenia was observed in 3 patients but HIV serology was negative in all cases. Paraneoplasic DM was observed in 3 cases. Death occurred in 5 cases due to the cancer-related, pulmonary and infectious complications. Based on the findings of this study, the three main features of DM and PM in Senegal are flagellated and often pruriginous erythema, cardiac and interstitial lung disease, and peripheral neural involvement.

Individual radiation therapy patient whole-body phantoms for peripheral dose evaluations: method and specific software.

This study presents a method aimed at creating radiotherapy (RT) patient-adjustable whole-body phantoms to permit retrospective and prospective peripheral dose evaluations for enhanced patient radioprotection. Our strategy involves virtual whole-body patient models (WBPM) in different RT treatment positions for both genders and for different age groups. It includes a software tool designed to match the anatomy of the phantoms with the anatomy of the actual patients, based on the quality of patient data available. The procedure for adjusting a WBPM to patient morphology includes typical dimensions available in basic auxological tables for the French population. Adjustment is semi-automatic. Because of the complexity of the human anatomy, skilled personnel are required to validate changes made in the phantom anatomy. This research is part of a global project aimed at proposing appropriate methods and software tools capable of reconstituting the anatomy and dose evaluations in the entire body of RT patients in an adapted treatment planning system (TPS). The graphic user interface is that of a TPS adapted to obtain a comfortable working process. Such WBPM have been used to supplement patient therapy planning images, usually restricted to regions involved in treatment. Here we report, as an example, the case of a patient treated for prostate cancer whose therapy planning images were complemented by an anatomy model. Although present results are preliminary and our research is ongoing, they appear encouraging, since such patient-adjusted phantoms are crucial in the optimization of radiation protection of patients and for follow-up studies.

[Assessment of medical management of heart failure at National Hospital Blaise COMPAORE]. / Évaluation de la prise en charge médicale de l'insuffisance cardiaque à l'hôpital national Blaise COMPAORE.

AIM: The aim of this study was to assess the quality of medical management of heart failure at the National Hospital Blaise Compaoré according to the international guidelines. PATIENTS AND METHODS: A retrospective study was performed including consecutive patients admitted for heart failure documented sonographically from October 2012 to March 2015 in the Medicine and Medical Specialties Department of National Hospital Blaise Compaore with a minimum follow-up of six weeks. Data analysis was made by the SPSS 20.0 software. RESULTS: Eighty-four patients, mean age of 57.61±18.24 years, were included. It was an acute heart failure in 84.5% of patients with systolic left ventricular function impaired (77.4%). The rate of prescription of different drugs in heart failure any type was 88.1% for loop diuretics; 77.1% for angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and 65.5% for betablockers. In patients with systolic dysfunction, 84.62% of patients were received the combination of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers and 75.38% for betablockers. Exercise rehabilitation was undergoing in 10.7% of patients. The death rate was 16.7% and hospital readmission rate of 16.7%. CONCLUSION: The prescription rate of major heart failure drugs is satisfactory. Cardiac rehabilitation should be developed.

Rapid and sensitive detection of Avibacterium paragallinarum in the presence of other bacteria using a 5' Taq nuclease assay: a new tool for diagnosing infectious coryza.

A 5' Taq nuclease assay specific for Avibacterium paragallinarum was designed and optimized for use in diagnosing infectious coryza. The region chosen for assay design was one of known specificity for Av. paragallinarum. The assay detected Av. paragallinarum reference strains representing the three Page and the eight Kume serovars, and field isolates from diverse geographical locations. No cross-reactions were observed with other Avibacterium species, with other bacteria taxonomically related to Av. paragallinarum nor with bacteria and viruses likely to be present in swabs collected from suspected infectious coryza cases. The detection limit for the assay was 6 to 60 colony-forming units per reaction. Twenty-two out of 53 swabs collected from sick birds reacted in the 5' Taq nuclease assay, whereas Av. paragallinarum was not isolated from any of the swabs. All of the 22 swabs yielded other bacteria in culture. The presence of Av. paragallinarum in the swabs was also demonstrated by sequencing, thereby confirming the ability of the assay to detect Av. paragallinarum in the presence of other bacteria. The ability to quantify bacterial load in the swabs using the 5' Taq nuclease assay was demonstrated.

[Prevalence of oro-dental injuries in wrestling in Senegal]. / Prévalence des traumatismes bucco-dentaires dans la lutte avec frappe au Sénégal.

Wrestling is a sport that is deeply-rooted in Senegalese cultural values. It is a popular sport that comes from local traditions but that has been influenced by boxing. This influence has made wrestling evolve to include the practice of boxing without gloves. Howeve, this practice causes many traumas in the mouth and teeth. The general objective of this study is to determine the frequency of the traumas among wrestlers who practice this form of wrestling associated with boxing. The specific objectives are to appreciate the bucco-dental conditions of the wrestlers, to evaluate the frequency and nature of the traumas in the intention to make recommendations and offer perspectives. 63.2% of wrestlers have at least presented a buckle or dental trauma. 28.8% of bucco-dental traumas occur among young wrestlers between 25 and 30 years and, 22.4% relate to the group between 19 and 24 years. 24.8% of bucco-dental traumas occur among wrestlers of the first category, followed by these of the second category with 21.6%, the fourth category with the lowest rate, 4% being last. It has been noted that 60% of buck-dental traumas occur in championship matches. 77.2% of dental and bucco traumas affect the upper jaw while. 22.8% affect the lower jaw. Affect teeth are often the group incisivo-canin. The National committee for the Management of wrestling in Senegal should make mandation the wearing of adapted gloves to attenuate the impact of blows. The Committee could also ban the inclusion of boxing practices in traditional wrestling and make compulsory the wearing of teeth protect in devices to minimize cases of bucco-dental traumas.

Management of necrotizing and non-necrotic bacterial erysipelas of the face in tropical areas: a series of four cases and a review of the literature.

The necrotizing and not necrotizing acute bacterial dermohypodermitis (DHD) are acute bacterial infections of tissues situated between the skin and the muscles. The localizations of the face are infrequent, and sometimes put diagnostic difficulties with other current facial dermatosis. We report in this article 4 cases of DHD of the face with skin source, hospitalized in the service of the Infectious and Tropical Diseases of the Teaching Hospital Yalgado Ouédraogo of Ouagadougou (Burkina Faso). The objective is to make a current situation of their etiologies and complications, and to look for the difficulties to take care of them in a country with limited resources. The patient's care journey for this disease is long while it constitutes a medical or medical-surgical emergency. Imaging, which is essential for the diagnosis of heart valve disease and the daunting complications of necrotizing fasciitis and mediastinitis, is generally available only in tertiary hospitals. Antibiotic therapy is most often inadequate or insufficient. Anti-inflammatories, widely used, according to several authors contribute to serious forms and excess mortality. Health workers in resource-limited settings need to be better educated and guidelines issued to recognize the signs of this condition in order to enable early referral of patients in specialized settings. In addition, education of the population and hygiene awareness of skin lesions should be a priority to reduce complications.