ABSTRACT
Epididymal tuberculosis is rare and often presents diagnostic difficulties. It may be indicative of a disseminated form of the infection, which is the case of our patient. A 19-year-old man, with no past medical history, was admitted for a swollen painful left scrotum that had been evolving for 8 months. He had undergone an orchiectomy and the anatomopathological examination was consistent with epididymal tuberculosis. The radiological investigations had revealed other localizations of the infection: lymphatic, pulmonary, parietal and osteoarticular tuberculosis. Anti-tuberculosis therapy was introduced. However, in the 4th month of treatment, the patient developed seizures. A cerebral magnetic resonance imaging was practiced, concluding to cerebral tuberculomas. Anti-tuberculosis treatment was continued associated to an anticonvulsant with a favourable outcome. The originality of our observation resides in the mode of revelation of a disseminated paucisymptomatic tuberculosis, by an epididymal localization, in an immunocompetent patient.
Subject(s)
Antitubercular Agents , Epididymis , Immunocompetence , Magnetic Resonance Imaging , Tuberculosis, Male Genital , Humans , Male , Young Adult , Antitubercular Agents/administration & dosage , Epididymis/pathology , Epididymis/microbiology , Tuberculosis, Male Genital/diagnosis , Tuberculosis, Male Genital/drug therapy , Orchiectomy , Seizures/etiology , Anticonvulsants/administration & dosage , Tuberculoma, Intracranial/diagnosis , Tuberculoma, Intracranial/drug therapyABSTRACT
BACKGROUND: Influenza infection is a highly contagious viral disease. It may cause several nosocomial outbreaks. This study aimed to evaluate the knowledge and attitudes of healthcare workers (HCWs) about influenza vaccination and to identify factors associated with the uptake of influenza vaccination. METHODS: We conducted a cross-sectional study over 5 months between November 2021 and March 2022. Data was collected using an anonymous self-administered questionnaire. We included all HCWs at Taher Sfar University Hospital who were willing to participate in the study. RESULTS: A total of 395 HCWs were included. They were mainly women (78.7%) with an average age of 27 years. The medical personnel was the largest group (67.8%). Most respondents considered the vaccination to be optional and knew that it should be renewed every year, but 97.5% of them judged the efficacy of the vaccine to be low. The influenza vaccination uptake was only 20.2%. The main reasons for accepting vaccination were to protect patients and families. However, misconceptions about the severity and the risk of influenza and the belief that barrier measures were sufficient to prevent infection were the main causes of avoiding vaccination. The factors associated with adherence to vaccination were being a medical professional, old age, longer professional experience, and considering vaccination to be mandatory for HCWs. CONCLUSION: Our study showed a low adherence to influenza vaccination with misconceptions about vaccine efficacy and safety. More efforts are needed to improve the knowledge of HCW about the vaccine and boost the adherence rates.
ABSTRACT
Acute pancreatitis is a sudden inflammation affecting the exocrine region of the pancreatic parenchyma. Infectious etiologies are rare. Here we report an exceptional case of a 44-year-old woman from a rural area who was referred to our hospital with fever and abdominal pain. A physical examination revealed pale skin and epigastric tenderness. Thoracoabdominal computed tomography revealed a Balthazar score of D. Serum laboratory findings revealed hemolytic anemia, hepatic cytolysis, and high C-reactive protein level. Calcium and lipase levels were normal. There was no history of recent trauma, alcohol consumption, or drug intoxication. The diagnosis of "query" pancreatitis was confirmed by serological Coxiella burnetii positivity. Oral doxycycline 200 mg daily was initiated. The clinical evolution was favorable. To our knowledge, no association between acute pancreatitis and hemolytic anemia caused by C. burnetii was reported previously. Q fever must be considered in cases of acute pancreatitis, especially when the patient is from a rural area or has a high-risk profession.
ABSTRACT
Joint involvement in COVID-19 may occur at different stages of the disease and maybe represented by non-specific arthralgia or by acute arthritis. We report two cases of COVID-19 infection that were complicated by postviral reactive arthritis. Case 1: A 47-year-old male was presented 20 days after a COVID-19 infection with acute right knee arthritis. On biologic data, erythrocyte sedimentation rate and C-reactive protein were normal, and immunologic data were negative. A joint puncture was performed showing a turbid fluid. Testing for microcrystals was negative, as well as the synovial fluid culture. An infectious investigation was conducted, which was negative. The patient's complaints improved significantly, with analgesics and non-steroidal anti-inflammatory drugs (NSAID). Case 2: A 33-year-old female presented with acute left knee arthritis evolving for 48 h, free of fever, after a COVID-19 infection treated 15 days ago. On examination, besides knee arthritis, the osteoarticular examination was normal. A biological inflammatory syndrome was noted in laboratory tests. A yellow fluid with multiple PNN was detected in the joint fluid aspiration, with a negative culture. The patient was treated by analgesics and NSAID. The follow-up was highlighted by the arthritis resolution. Conclusion: Both of our cases are consistent with what has already been reported in the literature confirming the development of PostCOVID arthritis and strengthen the impending necessity of wider studies to identify rheumatologic manifestations in the short- and long-terms after surviving COVID-19.
