An Evaluation of Renal Care received by Human Immunodeficiency Virus (HIV) Patients admitted in a Tertiary Hospital in Sierra Leone.

INTRODUCTION: The burden of HIV is on the rise and patients with HIV are also vulnerable to renal impairment from both acute and chronic causes. This study sets out to evaluate renal care received by such patients. METHODS: The study was conducted at Connaught Hospital, the main tertiary hospital (for medical and surgical cases) in the country. A retrospective review of all admitted patients with HIV between January and December 2019. Data was collected using a well- structured study proforma. RESULTS: A total of 230 patients were admitted with HIV during the study period. The mean age of patients was 36.9 ± (11.5) years with a female preponderance of 61.3%. A vast majority of the patients (54.8%) could afford to do some renal investigations and only 13.9% were seen by renal physicians; 69.1% of patients with azotaemia died while on admission. CONCLUSION: The extent of renal care observed from the study was poor because the majority of the patients were not seen by renal physicians and could not afford renal investigations. Also, the occurrence of renal impairment in patients with HIV suggests a poor prognosis.

INTRODUCTION: Le fardeau du VIH est en augmentation et les patients séropositifs sont également vulnérables à l'insuffisance rénale due à des causes aiguës et chroniques. Cette étude a pour but d'évaluer les soins rénaux reçus par ces patients. MÉTHODES: L'étude a été menée à l'hôpital Connaught, le principal établissement tertiaire (pour les cas médicaux et chirurgicaux) du pays; un examen rétrospectif de tous les patients admis avec le VIH entre janvier et décembre 2019. Les données ont été recueillies à l'aide d'un proforma d'étude bien structuré. RÉSULTATS: Un total de 230 patients ont été admis avec le VIH au cours de la période d'étude. L'âge moyen des patients était de 36,9±(11,5) ans avec une prépondérance féminine de 61,3%. La grande majorité des patients (54,8 %) pouvaient se permettre de faire quelques examens rénaux et seuls 13,9 % ont été vus par des médecins spécialisés dans les maladies rénales; 69,1 % des patients atteints d'azotémie sont décédés pendant leur admission. CONCLUSION: L'étendue des soins rénaux observés dans cette étude est faible car la majorité des patients n'ont pas été vus par des médecins rénaux et ne pouvaient pas se permettre de faire des examens rénaux. De plus, la présence d'une insuffisance rénale chez les patients atteints du VIH suggère un mauvais pronostic. Mots clés: Soins rénaux, patients VIH, Hôpital tertiaire, Sierra Leone.

Helical plasma filaments from the self-channeling of intense femtosecond laser pulses in optical fibers: publisher's note.

This publisher's note contains a correction to Opt. Lett.47, 1 (2022)10.1364/OL.445321.

Helical plasma filaments from the self-channeling of intense femtosecond laser pulses in optical fibers.

We experimentally and numerically study the ignition of helical-shaped plasma filaments in standard optical fibers. Femtosecond pulses with megawatt peak power with proper off-axis and tilted coupling in the fiber core produce plasma skew rays. These last for distances as long as 1000 wavelengths thanks to a combination of linear waveguiding and the self-channeling effect. Peculiar is the case of graded-index multimode fibers; here the spatial self-imaging places constraints on the helix pitch. These results may find applications for fabricating fibers with helical-shaped core micro-structuration as well as for designing laser components and three-dimensional optical memories.

Rainbow Archimedean spiral emission from optical fibres.

We demonstrate a new practical approach for generating multicolour spiral-shaped beams. It makes use of a standard silica optical fibre, combined with a tilted input laser beam. The resulting breaking of the fibre axial symmetry leads to the propagation of a helical beam. The associated output far-field has a spiral shape, independently of the input laser power value. Whereas, with a high-power near-infrared femtosecond laser, a visible supercontinuum spiral emission is generated. With appropriate control of the input laser coupling conditions, the colours of the spiral spatially self-organize in a rainbow distribution. Our method is independent of the laser source wavelength and polarization. Therefore, standard optical fibres may be used for generating spiral beams in many applications, ranging from communications to optical tweezers and quantum optics.

Experimental observation of self-imaging in SMF-28 optical fibers.

Spatial self-imaging, consisting of the periodic replication of the optical transverse beam profile along the propagation direction, can be achieved in guided wave systems when all excited modes interfere in phase. We exploited material defects photoluminescence for directly visualizing self-imaging in a few-mode, nominal singlemode SMF-28 optical fiber. Visible luminescence was excited by intense femtosecond infrared pulses via multiphoton absorption processes. Our method permits us to determine the mode propagation constants and the cutoff wavelength of transverse fiber modes.

Spatial beam self-cleaning and supercontinuum generation with Yb-doped multimode graded-index fiber taper based on accelerating self-imaging and dissipative landscape.

We experimentally demonstrate spatial beam self-cleaning and supercontinuum generation in a tapered Ytterbium-doped multimode optical fiber with parabolic core refractive index profile when 1064 nm pulsed beams propagate from wider (122 µm) into smaller (37 µm) diameter. In the passive mode, increasing the input beam peak power above 20 kW leads to a bell-shaped output beam profile. In the active configuration, gain from the pump laser diode permits to combine beam self-cleaning with supercontinuum generation between 520-2600 nm. By taper cut-back, we observed that the dissipative landscape, i.e., a non-monotonic variation of the average beam power along the MMF, leads to modal transitions of self-cleaned beams along the taper length.

[Epidemiology of primary lung cancer among non-smokers in Senegal]. / Épidémiologie des cancers bronchopulmonaires primitifs des non-fumeurs au Sénégal.

INTRODUCTION: According to global data for 2002, one quarter of new cases of primary bronchopulmonary cancer were non-smokers. We undertook this study with the aim of describing the epidemiological characteristics of non-smokers with primary bronchopulmonary cancer in the Dakar region of Senegal. METHODS: A multicenter descriptive study that included all non-smokers who presented with primary bronchopulmonary cancer between January 1st 2014 and December 31st 2015. The data were captured on an Excel file and then transferred to Epi InfoTM 7 software for analysis. RESULTS: The rate of diagnosis for primary bronchopulmonary cancers was 72.1 %. The prevalence of non-smokers was 33.3 %. The sex ratio was 1.27. The average age was 54.6 years. More than a third of the sample were housewives. Carpenters and craftsmen exposed to metals predominated. Exposure to cooking oils was reported in one case. Three patients presented sequelae of pulmonary tuberculosis. Adenocarcinoma was the most common histological type and predominated in young subjects. CONCLUSION: The proportion of primary bronchopulmonary cancers diagnosed among non-smokers is increasing in Dakar. An analytical study of suspected risk factors would be helpful for prevention.

[Prevalence Of Tooth Decay In Children From Age 3 To 14 At The Department Of Odontology Of Militairy Hopital Of Bamako (IHB) In Mali]. / Prevalence De La Carie Dentaire Chez Les Enfants De 3 A 14 Ans Dans Le Service D'Odontologie De L'Infirmerie Hopital Militaire De Bamako (IHB) Au Mali.

This was a cross-sectional, descriptive study lasting 8 months from 20 January to 20 September 2013, carried out in the Department of Dentistry of the Bamako IHB Military Hospital. Thus, out of 263 children surveyed, 178 cases of tooth decay were recorded, ie 67.68%. Females accounted for 97 cases or 54.49% with a sex ratio of 1.2; the 3- to 6-year age group accounted for 72 cases, or 40.45%. School children accounted for 85.39% of cases. The children who brushed represent 168 cases or 94.38%. Those who brushed once were the most represented with 145 cases or 86.30%. Almost all patients had consulted for swelling and pain. The group of lower right and left lower temporal molars were the most represented with respectively 24.71% and 28.09%. Temporary teeth were 103 (71.0%) were mainly the most affected. Stage 3 caries known as pulp according to the classification of early childhood caries represented 145 cases, ie 81.46%. The lower jaw represented 142 cases, ie 77.76%. Oral health plays an important role in children to maintain oral functions. It is necessary for eating, developing speech and a positive self-image. It is therefore time to focus on education campaigns, information for behavioral change in oral hygiene and the use of anti-caries adjuvants in children.

Il s'agissait d'une étude transversale, descriptive d'une durée de 8 mois allant du 20 Janvier au 20 Septembre 2013 réalisée dans le service d'Odontologie de l'Infirmerie Hôpital Militaire de Bamako IHB. Ainsi, Sur 263 enfants enquêtés 178 cas de carie dentaire ont été recensés soit une prévalence de67,68 %. Le sexe féminin a représenté 97 cas soit 54,49 % avec un sexe ratio de 1,2. La tranche d'âge de 3 à 6 ans a représenté 72 cas soit 40,45 %.Les enfants scolarisés ont représenté 85,39 % des cas. Les enfants qui se brossaient représentent 168 cas soit 94,38 %. Ceux qui se brossaient une fois ont été les plus représentés avec 145 cas soit 86,30%. La quasi-totalité des patients avaient consulté pour tuméfaction et douleur.Le groupe des molaires temporaires inferieures droite et gauche ont été les plus représentées avec respectivement 24,71% et 28,09 %.Les dents temporaires soient 103 (71,0%) ont été principalement les plus affectées. La carie du stade 3 dite pulpaire selon la classification de la carie de la petite enfance a représenté 145 cas soit 81,46 %. Le maxillaire inferieur a représenté 142 cas soit 77,76%.La santé bucco-dentaire joue un rôle important chez les enfants pour maintenir les fonctions orales. Elle est nécessaire pour manger, développer la parole et une auto-image positive. Il est donc temps de mettre l'accent sur les campagnes d'éducation, information pour un changement de comportement face à l'hygiène bucco-dentaire et à l'utilisation des adjuvants anti carieux chez les enfants.

[Sandflies Fauna of the Focus of Keur Moussa: Current Data on Diversity and Seasonal Variations (Thies, Senegal)]. / Faune phlébotomienne du foyer leishmanien de Keur Moussa : données actuelles sur la diversité et variations saisonnières (Thiès, Sénégal).

An inter-epidemic oversight was conducted in the cutaneous leishmaniasis focus of Keur Moussa (Thies region) between June 2015 and October 2016, more than 20 years after the last epidemic. The three sampling methods (adhesive traps, CDC light traps, and indoor pyrethroids sprays) allowed the capture of 1,746 sand flies belonging to 2 genera and 24 species, those involved in the transmission of leishmaniasis in Senegal, as well as 11 new species for the focus. The vector of human cutaneous leishmaniasis in Senegal, Phlebotomus duboscqi Neveu-Lemaire, 1906, represents 10.9% of this fauna. Sergentomyia schwetzi, one of the species involved, with Sergentomyia dubia and Sergentomyia magna, in the transmission of canine leishmaniasis in Senegal, is the most abundant species with 38.1% of the samples. The other two species have individually smaller percentages. Seasonal variations of the abundance show an intense activity of sandflies at the end of the dry season under the influence of high average temperatures and a humidity exceeding 50%. Rains are a limiting factor. According to the enrichment of the fauna and the high density of the different vectors of leishmaniasis in this focus, particularly P. duboscqi, a specific importance should be given for this focus in order to prevent occurrence of epidemics.

Une surveillance interépidémique a été menée au niveau du foyer de leishmaniose cutanée de Keur Moussa (région de Thiès) entre juin 2015 et octobre 2016, soit plus de 20 ans après la dernière épidémie. Les trois méthodes d'échantillonnage utilisées (papiers huilés, pièges lumineux CDC et pulvérisations intradomiciliaires avec des pyréthrinoïdes) ont permis la capture de 1 746 phlébotomes appartenant à deux genres et 24 espèces, celles impliquées dans la transmission des leishmanioses au Sénégal et 11 espèces nouvelles pour le foyer. Le vecteur de la leishmaniose cutanée humaine au Sénégal, Phlebotomus duboscqi Neveu-Lemaire, 1906, représente 10,9 % des captures. Sergentomyia schwetzi, l'une des espèces impliquées, avec Sergentomyia dubia et Sergentomyia magna, dans la transmission de la leishmaniose canine au Sénégal, est la plus abondante avec 38,1 % des captures. Les deux autres espèces ont des pourcentages individuels moins importants. Les variations saisonnières d'abondance montrent une intense activité des phlébotomes en fin de saison sèche sous l'influence des températures moyennes élevées et d'une humidité dépassant les 50 %. La pluie constitue un facteur limitant. En vue de prévenir la survenue d'épidémies, une importance particulière devra être accordée à ce foyer, vu l'enrichissement de la faune et les densités élevées des différents vecteurs de leishmanioses dans ce foyer, en particulierP. duboscqi.

Prevention of isoniazid toxicity by NAT2 genotyping in Senegalese tuberculosis patients.

Isoniazid (INH), recommended by WHO (World Health Organization) in the treatment of tuberculosis (TB), is metabolized primarily by the genetically polymorphic N-acetyltransferase 2 (NAT2) enzyme. The human population is divided into three different phenotypic groups according to acetylation rate: slow, intermediate, and fast acetylators. The objective of this study was to explore the relationship between NAT2 genotypes and the serum concentrations of INH. Blood samples from 96 patients with TB were taken for the analysis. NAT2 polymorphisms on coding region were examined by polymerase chain reaction (PCR) direct sequencing; the acetylation status was obtained by measuring isoniazid (INH) and its metabolite, acetylisoniazid (AcINH) in plasma was obtained by using the liquid chromatography coupled to mass spectrometry. TB patients were distributed into two groups of fast and slow acetylators according to the acetylation index calculated based on the plasma concentration of INH in the 3rd hour (T3) after an oral dose. Our PCR analysis identified several alleles, where NAT2*4, NAT2*5A, NAT2*6A, and NAT2*13A were the most important. The concentrations of INH varied between 1.10 mg/L and 13.10 mg/L at the 3rd hour and between 0.1 and 9.5 mg/L at the 6th hour. The use of the acetylating index I3 allowed the classification of tested patients into two phenotypic groups: slow acetylators (44.3% of TB patients), and rapid acetylators (55.7%). Patient's acetylation profile provides valuable information on their therapeutic, pharmacological, and toxicological responses.

[Prevalence of decreasing vitamin D reserves in black patients undergoing intermittent hemodialysis in Dakar (Senegal): 37 cases]. / Prévalence de la baisse des réserves en vitamine D chez les sujets à peau noire en hémodialyse périodique vivant à Dakar (Sénégal) : à propos de trente-sept cas.

It is now established that vitamin D acts as a steroid hormone via a nuclear receptor to perform its varied functions in mineral metabolism. Very few studies in sub-Saharan Africa, and in Senegal in particular, have focused on the prevalence of low vitamin D reserves in black individuals living in this sunny region. We conducted this study to assess the prevalence of a drop in vitamin D reserves in a population of blacks undergoing intermittent hemodialysis. This descriptive study took place at three hemodialysis centers in Dakar and included 37 patients whose 25-hydroxyvitamin D (25-OH-D) levels had been assayed. The patients' mean age was 51 years, and their sex ratio 1.49. The average concentration of 25-OH-D was 70 nmol/L. Below-normal reserves were found in 23 patients (62.2%), especially among those aged 50-75 years. All patients with low 25-OH-D reserves received vitamin D3 supplementation at a dose of 100,000 IU of cholecalciferol per month. This supplementation normalized 25-OH-D levels in the 10 patients subsequently tested. Given the small sample size, a study with a larger number of patients is needed to reach a conclusion about the exact prevalence of low vitamin D reserves in this population and to investigate possible associated factors.

[The primary pulmonary MALT lymphoma: a rare lung tumor]. / Le lymphome pulmonaire primitif de type MALT: une tumeur pulmonaire rare.

The primary pulmonary lymphoma is a rare disease, representing 0.5 to 1% of the malignant lung tumors. In our countries, in spite of the increasing prevalence of the pulmonary tumors, aggravated by smoking and environmental factors, any case report of the primary pulmonary lymphoma is notified. We report a confirmed case of MALT lung lymphoma that is managed in our hospital. Mr. S.B., 68-year-old man, not smoking, without particular professional exhibition, is admitted for a chronic cough with blood-streaked sputum, dyspnea, chest pain and loss of weight. His symptomatology is evolving for 4months. In the examination, the general health was passable and he presented a pulmonary condensation syndrome at right. The physical examination of others systems was normal. There was a biological inflammatory syndrome. The bacteriological examinations of the bronchial expectorations were negative. The chest CT showed bilateral alveolar opacities at the upper, with attraction of the fissures, without nodes. The bronchoscopy showed anomalies of the bronchial mucous membrane in 2 superior lobes. The perendoscopiques biopsies confirmed a MALT lung lymphoma. We did not find other localizations. Chemotherapy was proposed to our patient with favorable evolution. The MALT primary lung lymphoma must not be underestimated. Clinical manifestations and radiological characteristics are no specific and it's necessary to eliminate a lung cancer or tuberculosis in our countries. The difficulties of their diagnostic are intensified by the not availability of an adequate technical tray.

Encapsulating peritoneal sclerosis.

Encapsulating peritoneal sclerosis (EPS) is a rare but potentially lethal complication of peritoneal dialysis (PD). Peritoneal tuberculosis is considered an etiologic factor. We report a case of EPS in a 40-year-old man who was switched to hemodialysis because of peritoneal tuberculosis after 2 years of PD. Because of the persistence of gastrointestinal symptoms and cachexia, laparoscopic exploration was performed, which revealed an important thickening of the peritoneal membrane sheathing the intestinal loops. Accordingly, a diagnosis of EPS was made. Anti-tuberculosis treatment associated with a low dose of corticosteroids stabilized the disease.

[Lupus nephropathy in black patients with systemic lupus erythematosus in Senegal: 43 cases]. / Néphropathie lupique chez les sujets génétiquement pigmentés vivant au Sénégal : à propos de quarante-trois cas.

UNLABELLED: This study sought to assess the prevalence of lupus nephropathy and to determine its clinical, histological, therapeutic and outcome profiles. PATIENTS AND METHODS: This retrospective study examined records covering a 10-year period from 1999 to 2009 at the nephrology department of the Aristide Le Dantec University Hospital Center. RESULTS: The records showed 43 patients with systemic lupus erythematosus (SLE), and 72% had lupus nephritis. The patients' mean age was 32.9 years; 40 were women and 3 men, for a sex ratio of 0.075. The lupus nephritis led to discovery of SLE in 27.9%. The mean proteinuria concentration was 2.01 g/dL. Seventeen patients had impaired renal function, and 26 had renal biopsies. It found class II nephritis in 2 patients, class IV in 10, and class V in 12. In addition, fifteen patients received combined corticosteroid + immunosuppressant treatment. Four patients died during the study period, one from SLE activity, two from complications of renal failure, and the fourth from sepsis. CONCLUSION: A larger study would be useful to assess more acurately the prevalence of various classes and severity of lupus nephropathy among blacks living in sub-Saharan Africa.

Contribution to the study of particle resuspension kinetics during thermal degradation of polymers.

Experimental results are reported on the resuspension of particles deposited on polymer samples representative of glove boxes used in the nuclear industry, under thermal degradation. A parametric study was carried out on the effects of heat flux, air flow rate, fuel type and particle size distribution. Small-scale experiments were conducted on 10 cm × 10 cm PolyMethyl MethAcrylate (PMMA) and PolyCarbonate (PC) samples covered with aluminium oxide particles with physical geometric diameters of 0.7 and 3.6 µm. It was observed for both polymer (fuel) samples that heat flux has no effect on the airborne release fraction (ARF), whereas particle size is a significant parameter. In the case of the PMMA sample, ARF values for 0.7 and 3.6 µm diameter particles range from 12.2% (± 6.2%) to 2.1% (± 0.6%), respectively, whereas the respective values for the PC sample range from 3.2% (± 0.8%) to 6.9% (± 3.9%). As the particle diameter increases, a significant decrease in particle release is observed for the PMMA sample, whereas an increase is observed for the PC sample. Furthermore, a peak airborne release rate is observed during the first instants of PMMA exposure to thermal stress. An empirical relationship has been proposed between the duration of this peak release and the external heat flux.

[Quality of life in hemodialysis patients in Dakar: differences for the tropics?]. / Qualité de vie des patients en hémodialyse à Dakar (Sénégal): quelles particularités pour les personnes vivant en milieu tropical ?

UNLABELLED: In recent years, measuring quality of life (QoL) to quantify the impact of disease on patients' lives has become widespread. We conducted a study to evaluate the QoL of hemodialysis patients in Dakar and to identify factors that influence it. PATIENTS AND METHODS: This cross-sectional study took place from May through July 2008 in two hemodialysis centers in the city of Dakar. It included all patients who had been undergoing dialysis for more than 3 months, were in stable clinical condition with no hospitalization in the previous month and consented to participate. QoL was assessed with the Kidney Disease Quality Of Life Short-Form version 1.2 (KDQoL-SF), which comprises 43 items specific to kidney disease as well as the 36 items of the SF-36. RESULTS: Our study included 60 patients. Their mean age was 50.5 years, and the male/female sex ratio was 0.9. The global mean score (for the SF-36 was 45.7 ± 25.5, 41 ± 24.4 for the physical dimension and 53.6 ± 27.3 for the mental health dimension. The mean global KDQoL score was 55.2 ± 24.0, 44.8 ± 26.1 for the physical dimension, and 54.8 ± 24.4 for the mental health dimension, 60.8 ± 21.3 for the specific dimension of dialysis and 78.4 ± 22.3 for patient satisfaction. The study shows that the QoL of 90% of our patients was impaired by their kidney disease. CONCLUSION: Studies that focus on QoL of dialysis patients are rare in Africa. This one showed an impaired QoL, especially for physical health, among our hemodialysis patients.

[Nocardiosis: 4 cases in Senegal]. / Nocardiose: 4 observations au Sénégal.

The purpose of this report is to describe four cases of nocardiosis observed over an eight-year period in medical units of Principal Hospital in Dakar, Senegal. It is a rare infection occurring mainly in people with weakened immune systems. Pulmonary forms are predominate and clinical and laboratory presentation can mimic pulmonary tuberculosis. Diagnosis should be suspected in patients presenting pulmonary infections and negative sputum bacilloscopy. Nocardia bacteria should be identified before starting antibiotic treatment. Patients require long-term antibiotic treatment with third generation cephalosporins or sulfamethoxazole-trimethoprim.

[Merkel cell carcinoma of the gingival mucosa in a black young adult]. / Carcinome à cellule de Merkel gingival chez un adulte jeune de race noire.

Merkel cell carcinoma (MCC) is a rare and aggressive primary neuroendocrine neoplasm of the skin with a poor prognosis. It occurs mainly in the skin of white elderly patients. Its occurrence in intraoral mucosal sites is rare. We report a rare case of MCC that arose in the gingival mucosa of young black adult.

[Peritoneal dialysis in a tropical area, a reality]. / Dialyse péritonéale en milieu tropical, une réalité.

INTRODUCTION: Chronic kidney disease is now regarded as amajor public health concern. This is especially true in developing countries where it accounts for significant morbidity, mortality and decreased life expectancy. The main problem for developing countries is the cost of dialysis. Indeed, the availability of peritoneal dialysis for renal replacement therapy is low in sub-Saharan Africa. Since March 2004 peritoneal dialysis has been available to some patients with end-stage renal disease in Senegal. The purpose of this study was to assess epidemiologic, clinical, technical patterns and outcomes in patients who underwent peritoneal dialysis in the first three years of the program. MATERIALS AND METHODS: This three-year retropective study identified 26 patients who underwent peritoneal dialysis for end-stage renal disease for a period of at least 15 days. Patients not meeting these criteria were not included. All patients had a Baxter type transfer set. Lactate-bicarbonate solution was used for countinuous ambulatory peritoneal dialysis. In 3 cases, Icodextrin- and amino-acid based-solutions were employed. In automated peritoneal dialysis, the Home Choice machine was used for all patients. Epidemiological, clinical/paraclinical data and outcomes were noted for each patient. RESULTS: Twenty-six patients were included in the study. Median age was 48 +/- 6 years with a M/F sex ratio of 1.17. Most patients (84%) were literate. Diabetic nephropathy and nephroangiosclerosis were the main causes of end-stage renal disease. The mean Charlson score was 3 (range, 2 to 5). Mean residual diuresis was 435 mL/day. The peritonitis rate was 1 per 20 patient months. Staphylococcus aureus and Pseudomonas aeruginosa were the most common germs. Six patients presented catheter infection: exit-site in 4 and tunnel in 2. Catheter obstruction occurred in three cases. At the end of the study, 6 patients were still in automated peritoneal dialysis and 8 in countinuous ambulatory peritoneal dialysis. Six 6 patients died and 6 were switched to hemodialysis. CONCLUSION: Peritoneal dialysis is available as a renal replacement therapy in Senegal. It has allowed end-stage renal disease patients greater autonomy in their working place.

[Pulmonary fibrosis and arterial hypertension revealing a chronic pulmonary schistosomiasis. An unusual diagnosis in Europe]. / Fibrose et hypertension artérielle pulmonaires révélant un poumon bilharzien chronique. Un diagnostic inhabituel en Europe.

We report on the case of a Senegalese woman who was hospitalised in Paris for dyspnea on exertion, revealing pulmonary fibrosis and arterial hypertension. With no evident etiology of this fibrosis, a surgical pulmonary biopsy was performed and revealed granulomatosis due to schistosomiasis. Diagnosis of chronic pulmonary schistosomiasis was obtained. The manifestations of the chronic pulmonary schistosomiasis include miliary and pulmonary arterial hypertension. Certain forms can lead to fibrosis as our case study illustrates and pose diagnostic problems outside parasitic endemic areas. Beside cases of acute schistosomiasis observed in tourists, the possibility of chronic forms of the disease in migrant originating from endemic areas should be recognised in industrialised countries.