Identification of The Main Intestinal Helminths of Local Breed Chickens (Gallus Gallus Domesticus Linnaeus, 1758) Reared in Traditional Mode in The Oran Region.

In order to gain a better etiological and epidemiological knowledge of the parasitic diseases of local breed chickens reared in extensive (traditional) mode, a study was carried out in the Oran region during the periods from February 2020 to April 2020. Ten chickens were examined by the helminthologic autopsy method to identify parasitic helminths in the digestive tract. Four species of helminths have been identified: two species of nematodes: Ascaridia galli and Heterakis gallinarum and two species of cestodes: Raillietina cesticillus and Raillietina tetragona. Six chickens were carriers of the parasites, for an overall level of infestation of 60 % with an average infestation of 7 parasites per chicken. The rate of parasitism and infestation varied from species to species, Heterakis gallinarum being the most dominant species. The estimate of the infestation rate by each group shows a predominance of nematodes with 62 parasites (88.5 %) compared to cestodes (8 parasites) with a significantly higher difference (P <0.05). The results obtained show that chickens of the local Gallus gallus domesticus breed in the Oran region are heavily infested by parasites including Heterakis gallinarum, the predominant species.

[Recurrent postpartum pyoderma gangrenosum and fatal cardiomyopathy]. / Pyoderma gangrenosum récidivant du post-partum et cardiomyopathie fatale.

BACKGROUND: We report a case of recurrent post-partum pyoderma gangrenosum (PG) complicated by post-partum cardiomyopathy (PPCM). PATIENTS AND METHODS: A 23-year-old woman presented with a previous medical history of aseptic abscess of the left breast in her fourth pregnancy, which developed after surgical drainage of an inflammatory ulceration treated by atraumatic topical care. During her fifth pregnancy, the patient presented a large and painful ulceration in relation to the scar of the Caesarean section, despite the introduction of broad-spectrum antibiotic therapy. Bacteriological samples were negative. Histological examination militated in favor of PG. One week after initiation of corticosteroid therapy, the patient suddenly showed signs of heart failure. Based on trans-thoracic echocardiography PPCM was diagnosed, and the outcome was fatal. DISCUSSION: This observation raises the question of the relationship between PG and pregnancy and describes the association of PG and PPCM. PG occurs rarely during pregnancy and it may be induced by the rise in G-CSF levels found in pregnant women. The association with PPCM seen in our patient could have been due to the development of an anti-angiogenic climate at the end of pregnancy, together with inflammatory myocardial aggression linked to the PG.

Systemic paraneoplastic vasculitis secondary to papillary carcinoma of the thyroid.

Systemic vasculitis secondary to thyroid carcinomas is exceptional. We report the case of a 55-year-old woman who presented with systemic vasculitis involving leucocytoclastic cutaneous vasculitis and renal disorders secondary to papillary thyroid carcinoma (PTC). Her symptoms resolved completely after total thyroidectomy. Other causes of vasculitis were excluded. To our knowledge, this is only the second case reported of systemic vasculitis associated with PTC in a paraneoplastic manner.

[Multiple facial nodules revealing disseminated cryptococcosis in an immunocompetent patient]. / Nodules multiples du visage révélant une cryptococcose disséminée chez un patient immunocompétent.

BACKGROUND: Cryptococcosis is a potentially severe infection that usually occurs in a setting of immunosuppression. Its occurrence outside of this context is rare. We report a case of disseminated cryptococcosis revealed by a spectacular skin disease in an immunocompetent patient. PATIENTS AND METHODS: A 40-year-old male patient had been presenting multiple nodules and tumors on his face for one month in a context of asthenia and intermittent fever. Histological examination of a skin biopsy revealed encapsulated yeasts strongly suggestive of Cryptococcus neoformans. Mycological examination of the skin biopsy and cerebrospinal fluid isolated Cryptococcus gattii. The blood cultures were positive. Brain MRI demonstrated cryptococcal parenchymal involvement. Screening for primary or secondary immunodeficiency was negative. The patient received amphotericin B 1mg/kg/day and fluconazole 600mg/day but died 2months after diagnosis. DISCUSSION: Cryptococcosis is a potentially severe infection caused by C. neoformans. This rare condition occurs most commonly in patients with profound deficiency in terms of cellular immunity. Although rare, the occurrence of cryptococcosis in immunocompetent patients is possible, and in this event the signs are highly polymorphic, which usually makes it very difficult to diagnose. The diagnosis of cryptococcosis is based on the identification by direct examination and after staining with India ink of encapsulated yeasts of the Cryptococcus genus. Culture on Sabouraud medium is essential for identification of the species. Treatment for disseminated cryptococcosis involves amphotericin B, often associated with flucytosine IV. In the event of meningitis infection in non-HIV patients, mortality continues to be around 15%, despite adequate medical treatment. CONCLUSION: Although rare, cryptococcosis can occur in immunocompetent subjects. The prognosis is severe even after treatment.

[Kaposi's disease: an unusual side-effect of topical corticosteroids]. / Maladie de Kaposi : un effet secondaire inhabituel des dermocorticoïdes.

BACKGROUND: Kaposi's sarcoma is an angiogenic tumour associated with HHV8 infection. There are several clinical forms, including those related to acquired immunosuppression. We report a case of nodular lesions in Kaposi's disease that appeared during treatment of bullous pemphigoid with topical corticosteroids. PATIENTS AND METHODS: A 74-year-old female patient presented bullous pemphigoid lesions on all four limbs that were treated with clobetasol cream, a topical corticosteroid. After 2 months of treatment, the patient noted the appearance of several asymptomatic purple, erythematous, papulonodular lesions of elastic consistency on her right thigh and both legs. The histological examination revealed Kaposi's disease with positive immunolabelling for HHV8 in the tumour cells. HIV serology was negative. The lesions disappeared 4 months after cessation of corticosteroid therapy and the patient was still in remission one year later. COMMENT: Authentic "Mediterranean" cutaneous Kaposi's disease was apparently revealed in this patient during treatment with extremely potent topical corticosteroids, before regressing completely on discontinuation of the medication. We discuss the various mechanisms that could have contributed to this side-effect of dermal corticosteroids, whose sustained application over a wide area caused HHV8 antigen reactivation.

[Specific tongue involvement revealing sarcoidosis]. / Atteinte linguale spécifique révélatrice d'une sarcoïdose.

BACKGROUND: Sarcoidosis is a multisystem granulomatous disease of unknown aetiology. Tongue involvement is extremely rare. Herein we report a new case. PATIENTS AND METHODS: A 65-year-old woman presented with a 6-month history of painless multiple nodules on the tongue. The patient also complained of xerostomia. Besides nodules on the tongue, physical examination revealed erythematous nodules on the dorsum of the hands and feet. A diagnosis of sarcoidosis with tongue, cutaneous and salivary gland involvement was made on the basis of these findings and further investigations performed. The patient's condition showed improvement with partial regression of tongue lesions after oral steroid therapy. DISCUSSION: Tongue involvement in sarcoidosis is exceedingly rare. It may be isolated or part of a generalized multisystem sarcoidosis. Nodules, indurations and swelling are the most common clinical manifestations. Management of tongue sarcoidosis is not consensual. Oral corticosteroids appear to be the most effective therapy. CONCLUSION: Sarcoidosis of the tongue should be considered when chronic unexplained nodules are noted. Diagnosis can easily be confirmed by a histological examination of mucosal biopsy.

[Pemphigus vulgaris: an unusual clinical presentation]. / Pemphigus vulgaire de présentation inhabituelle.

BACKGROUND: Pemphigus vulgaris is a bullous auto-immune disease affecting the skin and mucosa. It is characterised by acantholysis that results in the formation of intraepithelial bullous lesions. Herein we report a case distinguished by its unusual clinical presentation. PATIENTS AND METHODS: A 45-year-old man, a chronic smoker, consulted for hyperkeratotic lesions of the toes on the right foot present for 5 months. Examination revealed a violet colour of the toes associated with localised yellowish keratoderma on the sole of the foot and impaired toe nails, as well as impairment on the nails of the first, third and fourth fingers on the right hand. In addition, two hyperkeratotic plaques with crusts were noted on the patient's forehead. Histological examination of a biopsy sample taken from the nail bed of the fourth toe on the right foot showed suprabasal acantholysis with a characteristic tombstone appearance. Direct immunofluorescence confirmed the diagnosis of pemphigus. Oral corticosteroid therapy was initiated consisting of prednisone 1.5mg/kg per day. Improvement of the nail lesions and subsidence of the lesions on the patient's forehead occurred after three months of treatment. DISCUSSION: During the course of pemphigus, the nail findings most commonly reported in the literature are paronychia, onychomadesis and onycholysis. However, these signs are generally seen in patients with known pemphigus vulgaris and only rarely indicate bullous disease. The case we report illustrates a special situation in which pemphigus vulgaris was revealed by unusual skin and nail lesions.

[Giant seborrhoeic keratosis in an unusual site]. / Kératoses séborrhéiques géantes de siège inhabituel.

BACKGROUND: Seborrhoeic keratoses (SK) are benign tumours preferentially located on the head and trunk. We report a case of giant SK at an unusual site. PATIENTS AND METHODS: An 85-year-old man consulted for pigmented genital lesions present for 10 years. Clinical examination revealed small pigmented formations evoking SK and other pigmented, confluent and hyperkeratotic bordering plaques with a circinate contour. The latter lesions were biopsied, and histological findings were characteristic of SK and showed epidermal acanthosis associated with orthokeratotic invagination of the mucosa, resulting in the formation of characteristic wells. Treatment by electrocoagulation curettage was undertaken. DISCUSSION: SK are benign tumours that occur primarily in patients aged over 50 years. They are preferentially located in the trunk, head and neck. A genital site of SK is very unusual, with no more than 10 published cases. The cause of genital SK is as yet unknown, but data in the literature point to a possible role of chronic friction and HPV.

[Evaluation of the prescription of long-term systemic steroid-therapy associated measures]. / Mesures adjuvantes à une corticothérapie systémique prolongée : que faut-il prescrire ?

INTRODUCTION: To prevent the occurrence of corticosteroid's side effects, adjuvant measures are prescribed in a very different way depending on the practitioner's experience. The aim of this study was to assess the physicians' practices regarding the prescription of long-term corticosteroid therapy. METHODS: In May 2010, we realized a cross-sectional study among physicians in Ibn Sina University Hospital in Rabat. With a data collection form, we assessed the principal indications for prescribing steroids and the frequency of prescription of measures sometimes associated with systemic corticosteroid. RESULTS: Fifty-nine out of eighty physicians completed the data collection form (response rate: 69.4%). Calcium-vitamin D supplementation was recommended by most of the physicians. Half of them were prescribing biphosphonate therapy. Most of them propose a low-sodium, a low-fat and a low-carbohydrate dietary regimen. Regular physical exercise was recommended by 35% of physicians. Gastric protection was indicating by 54.4% of practicians and potassium supplementation by 42.1% of them. Finally, the recommendation for influenza vaccination, hydrocortisone prescription and Synacthen(®) test, varied between physicians. CONCLUSION: The prescription of adjuvant measures with a long-term corticosteroid therapy was very heterogeneous. There is no consensus regarding most of the measures.

Syndrome De Lyell Et Syndrome De Stevens-Johnson: Étude Rétrospective De 30 Cas.

Stevens-Johnson syndrome and Lyell syndrome are severe bullous drug reactions that can be life-threatening. The aim of this study is to describe the epidemiological, etiological, clinical, therapeutic and evolutionary data of patients hospitalized in our Dermatology Department. This is a retrospective descriptive study over a period of 10 years. All records of patients admitted to the Dermatology Department for these cutaneous adverse drug reactions were included. A total of 30 patients were recorded, with a male predominance. There were 18 cases of Lyell syndrome, 8 cases of Stevens-Johnson syndrome and 4 cases of overlap syndrome. The mean time to onset after drug administration was 7.5 days. The average skin area detached was 48%. Visceral involvement was frequently observed: pulmonary involvement, renal involvement, hepatic cytolysis and hematological involvement. The notion of medication was found in all our patients, with self-medication in 23% of cases. The reason for prescription was dominated by post-surgical anticonvulsant prophylaxis. All our patients received symptomatic treatment, and corticosteroid therapy was administered in only one patient for macrophagic activation syndrome. The mortality rate was of 17%. Skin area involved, presence of renal failure or respiratory distress were the main prognostic factors.