ABSTRACT
We conducted a retrospective study of meningococcal invasive diseases [MID] contracted in children in Tunis between January 1997 and January 2006. The purpose of this study is to specify the clinical, epidemiological, therapeutic and evolutionary features of these infections and to determine antimicrobial susceptibility and the antigenic formula of N. meningitidis isolates. During the study period, we have collected 79 cases of MID arising in children aged 3 days to 11 years. The majority of children's were less than of 4 years [57.3%]. We note a frequency of the MID in winter and in spring. The most frequent clinical shape was meningitis [53%]. Twenty one patients [26.6%] had a fulminant meningococcal disease. In our series, the rate of lethality was equal to 17.7%. Among the 46 meningococcal isolates, the most frequent serogroup was the B [73%] followed by C and A. A high heterogeneousness of the antigenic formulae was observed. The most frequent phenotype was NT: NST for the group B isolates and 4:P1.13 for the group C ones. N. meningitidis with reduced susceptibility to penicillin and to amoxicillin account for 54% and 10% of all isolates respectively. The cefotaxim and the rifampin were uniformly active
ABSTRACT
Introduction: The 3A syndrome or Allgrove syndrome is an autosomic recessive disease characterized by the association of oesophagus achalasia, alacrymie and suprarenal insufficiency. Neurological disorders can appear at any time of the course's disease and would be due to a neuropathy affecting the central nervous system as well as the peripheral nervous system
Patient and methods: From1991 to 2005, we noticed 22 cases of Allgrove syndrome. The follow-up of these patients enabled us to notify the neurological abnormalities appear later in the evolution
Results: neurological symptoms appear at any time of the course's disease. All cases were backward pupil. 8 patients had a nasal voice due to palate paralysis. 7 patients had xerostomia wich is included in the dry syndrome due to the degeneration of salivary glands. One patient had a neurological motor disorder and 3 patients had a sensitive disorders with loss of cold feeling and vasomotor disorders in the hands and feet. These symptoms appear after 4 years on average after diagnosis. An orthostatics hypotension was noticed among three patients as a dysautonomic sign
Conclusion: All of these data approve that neurological disorders appear at a variable time of the course's disease. This polyneuropathy affects the oesophagus and always leads to the recurrence of the digestives signs