[Cutaneous anthrax: seven cases]. / Maladie du charbon cutanée: sept cas.

BACKGROUND: Anthrax is an acute infection caused by the Gram-positive organism, Bacillus anthracis, which rarely affects humans under normal conditions. Depending on the mode of contamination, there are three distinct clinical forms: pulmonary, gastrointestinal and cutaneous. This type of infection is still common in the developing countries, a fact that should be borne in mind by examining doctors, and in particular by dermatologists. It is important to recognise the clinical aspects of this disease rarely encountered in clinical practice since any delay in treatment may have fatal consequences, as illustrated by our case reports. CASE REPORTS: Five men and two women of mean age 35years presented one or more cutaneous lesions of the upper limbs in all instances. All patients had a fever of 39-40 degrees C but none were presenting gastrointestinal or pulmonary signs. Neurological signs and/or disturbed consciousness were seen in three patients. Bacteriological diagnosis was based on isolation of B. anthracis in cultures of skin specimens. Treatment with parenteral or oral ciprofloxacin was initiated in six patients, and this therapy was combined with oral corticosteroids in three patients. A favourable outcome was achieved in four patients, while the remaining three patients died of their disease. DISCUSSION: Anthrax is an anthropozoonosis that has now become rare in the developed countries. The disease is contracted by humans through touching either animals killed by anthrax or the products thereof. The cases we report were subsequent to collective contamination of several members of a single family, probably due to contact with goats carrying the disease. If left untreated, cutaneous anthrax may progress in 5 to 20% of cases to septicaemia with potentially lethal central nervous system involvement. The only means of eradicating anthrax in animals, and thus in humans, is through animal vaccination.

Clinical and immunological status of a newly diagnosed HIV positive population, in Marrakech, Morocco.

OBJECTIVE: To evaluate the clinical and the immune status of newly HIV diagnosed patients, in Marrakech city and its neighboring area, in Morocco. METHODS: We performed a retrospective study on 235 patients who have been previously confirmed for HIV infection, and underwent a CD4 T cells using flow cytometry (FacsCount, Becton Dickinson®). RESULTS: The mean age of patients was 34,3 ± 8,4 years (range: 14-55), with a male predominance (sex-ratio M/F=1.4). On basis of clinical data of the patients, 62% (n=146) of them were categorized as "category C", 18.4% (n=43) as "category B", and 19.6% (n=46) as "category A" according to CDC (Center for Disease Control) HIV classification. Among all of them, 60.4% (n=142) had less than 200 CD4T cells, 26% (n=61) had between 200 and 499 CD4T cells, and only 13.6% (n=32) showed a number of CD4T cells less or equal to 500/mm(3). CONCLUSION: The results of this study reflect a significant delay in the diagnosis of HIV infected patients. Therefore, this delay may compromise timely management of HIV infected individuals and enhances propagation of the epidemic in our country. These data confirm the need for intensifying prevention efforts among high-risk population. Moreover, continuing education in HIV/AIDS among healthcare providers should be reinforced.