Respiratory cryptosporidiosis in two patients with HIV infection in a tertiary care hospital in Morocco.

Respiratory cryptosporidiosis is recognized as a late-stage complication in persons with AIDS. We report two cases of respiratory cryptosporidiosis in patients with HIV infection. The first patient was a 46-year-old person with chronic diarrhea, a two-month history of low-grade fever, progressive dyspnea and productive cough. The search for acid-fast bacillus, Pneumocystis jirovecii, Toxoplasma gondii and Cryptococcus sp. in sputum was negative on several samples. The modified Ziehl has shown oocysts of Cryptosporidium sp. in induced sputum. The patient's death occurred, due to electrolytes disorders. The second patient was a 45-year-old person hospitalized for chronic fluid diarrhea, complicated with weight loss, dry cough, dyspnea stage II and low-grade fever. The patient was HIV-positive with low CD4 count and pancytopenia. Acid-fast oocysts of Cryptosporidium sp. were observed in stool samples and induced sputum. The patient was treated daily with azithromycin 500  mg resulting of disappearance of gastrointestinal and respiratory disorders.

[Severe hypertriglyceridemia and macrophage activation syndrome: a case report]. / Hypertriglycéridémie majeure et syndrome d'activation macrophagique.

We report the case of a 36-year-old patient admitted for Macrophage Activation Syndrome (MAS), revealed by inflammatory dermo-hypodermal lesions, tumor syndrome, pancytopenia, biological cholestasis, increased lactate dehydrogenase rates and hemophagocytosis in skin biopsies. The patient also exhibited an exponential increase in triglycerides serum levels that reached 22 g/L. The patient died after multiple organ failure. This case illustrates the value of the hypertriglyceridemia in the diagnosis and monitoring of hemophagocytic syndrome but also highlights the difficulty in understanding its pathophysiology especially with several elements that contribute to its aggravation during the evolution of this syndrome.

[Gemella haemolysans brain abscess in a child with complex congenital heart disease]. / Abcès cérébral à Gemella haemolysans chez un enfant porteur d'une cardiopathie congénitale complexe.

Gemella haemolysans, a Gram positive cocci which are deemed to be the normal inhabitant of the mucous membranes of the oropharynx, has been recognized as a pathogen involved in abscess formation. The aim of this case report is to demonstrate that it is also involved in brain abscess in children. We report, to our knowledge, the first pediatric case of Gemella haemolysans brain abscess in an 11 years old child carrying a complex congenital heart disease (dextrocardia with single right ventricle) which evolved favorably under antibiotic therapy. Because of its similarity with Streptococcus viridans groupe, Gemella haemolysans often remains under-diagnosed in the laboratory. The contribution of microbiologists in its correct identification is very important.

IgG anti-toxoplasma antibodies among asymptomatic HIV-infected patients in Marrakesh-Morocco.

Detection and monitoring of anti-Toxoplasma gondii antibodies are of a great interest among human immunodeficiency virus (HIV)-infected patients, since cerebral toxoplasmosis is a life-threatening opportunistic infection within this vulnerable population. The IgG anti-T. gondii seroprevalence was assessed in 95 asymptomatic HIV-infected adults living in Marrakesh city and its surrounding areas. Our results showed a seroprevalence of 62.1%, which is high compared to most other countries. The mean of CD(4+) T-cells count of involved patients was 381.9cells/µl. Given these results, HIV-infected patients in Marrakesh region could be at high risk to develop toxoplasmosis disease, especially when CD(4+) T-cells count falls below 100cells/µl. Accordingly, there is a serious need of widening antiretroviral therapy and chemoprophylaxis against toxoplasmosis, when indicated, to ovoid toxoplasmosis reactivation among this population.