Features of patients with 2019 novel coronavirus admitted in a pneumology department: The first retrospective Tunisian case series.

AIM: On 2 March 2020, Tunisia has reported the first confirmed case of COVID-19. Since then, the disease has affected about 700 persons in the country. The purpose of our study was to report epidemiological, clinical, radiological and therapeutic features of patients with 2019-nCoV infection admitted in the pneumology department. METHODS: We extracted the data of the consequetive 20 patients managed in the department of pneumology B at Abderrahmen Mami hospital, from March, 26 to April, 8, 2020. RESULTS: The median age was 61 years old [41-85]. There were 9 men and 11 women.  Underlying disorders were observed in 16 patients (80%). Five patients were health care workers. Three patients did not have any known exposure. Common symptoms included fever (100%), shortness of breath (70%) and cough (70%). Computed tomography scans showed bilateral ground glass opacities in 7/9 cases. Fifteen patients received both chloroquine and azithromycin. Fourteen patients (70%) were discharged before April, 8, 2020. Reported complications were: hypokalemia (3 cases), pulmonary embolism (2 cases) and QT prolongation (1 case). One patient died from acute cardiac injury. CONCLUSION: Knowing the different aspects of moderate and severe forms of the disease can contribute to advance in infection control strategies.

Tuberculosis of the Thyroid Gland Presented as a Rapid Enlargement of a Preexisting Goiter.

Thyroid involvement with tuberculosis is an uncommon condition even in endemic countries. As its clinical presentation is not specific, diagnosis is often difficult and requires histopathological confirmation. Herein we report an observation of secondary tuberculosis of the thyroid gland in a woman with a type 2 diabetes mellitus and a primary hypothyroidism. She presented with a rapid enlargement of a preexisting goiter without compressive symptoms. The imaging exams showed a voluminous plunging multinodular thyroid gland and multiple bilateral lung nodules. Malignancy was suspected and the patient underwent a total thyroidectomy and a lung biopsy. Histopathological examination revealed multiple tuberculous foci involving both the thyroid gland and the lungs.

[Palliative chemotherapy of non small lung cancer in Tunisia. Prospective study of the cost and impact on the quality of life]. / Chimiothérapie palliative des cancers bronchiques non à petites cellules (CBNPC) métastatiques en Tunisie: etude prospective du coût et impact sur la qualité de vie.

BACKGROUND: Bronchopulmonary cancer is actually the first cancer in the world. In Tunisia, recent statistics are alarmous. The most bronchopulmonary cancer in tunisian series are diagnosis at metastatic states. AIM: To evaluate the cost of the global treatment by chemotherapy in patients with metastatic non small lung cancer and its impact over the quality of life in Tunisia. METHODS: It's a prospective study lead between January 2006 and Juin 2007 to evaluate the quality of life for patients hading metastatic non small lung cancer treated by palliative chemotherapy in Ibn Nafiss department in Abderrahmen Mami hospital.The evaluation of the quality of life is inspired by the questionnaire of EORTC: QLQC30 version 3 translated in en Arab language, filled before chemotherapy, after the le 3rd cycle, and at the end of the first ligne. The study of the cost is effected for the 2 protocols whose the most used in first ligne : Cisplatin-Vinorelbine (P-V) and Cisplatin- Gemcitabine (P-G) RESULTS: 30 patients had benefit from palliative chemotherapy based on P-V (18 cases) or P-G (12 cases). All patients had responded for the questionnaire in the opportunity moments. After 3 cycles of chemotherapy, we note an improve of the symptomatic, physical, activity, emotional and global health scales. In opposition, we note a deterioration of cognitive and social scales without any supplementary improvement(no significant difference) if we add other cycles in the twice protocols. At the same level of the benefit in term of quality of life and survival without supplementary toxicity, the choice is made by the less cost's protocol in other words P-V. CONCLUSION: Our results confirm the benefit from chemotherapy in term of survival and quality of life in our context, however, the important cost of the chemotherapy necessitate to rationalize the indications and the le choice of the treatments in this palliative indication.

[Allergic bronchopulmonary aspergillosis. A review of 3 cases]. / L'aspergillose broncho-pulmonaire allergique. A propos de 3 cas.

BACKGROUND: Allergic bronchopulmonary aspergillosis (ABPA) is a rare affection, initially described in 1952. Its pathophysiology incriminate several mechanisms in relation with the organism of the patient and the bronchial colonisation by the fongic agent. AIM: To report three cases of ABPA. CASES REPORT: Three patients had been treated for ABPA in Ibn Nafiss department in Abderrahmen Mami hospital in Ariana. ABPA had been discovered in the three cases by a cortico dependant asthma, refractory for different therapeutics. Positive diagnosis reposed in the 3 patients at 6 major and one minor criterion. Treatment was essentially based in corticotherapy. CONCLUSION: Positive diagnosis of ABPA is actually well established, however, its treatment, although based on corticotherapy, remind not clearly codified. Association of antifongic treatment may improve the prognosis.

[Pulmonary atinomycosis: a great clinical polymorphism]. / Actinomycose pulmonaire: un grand polymorphisme clinique.

BACKGROUND: Pulmonary actinomycosis is a rare bacteriological disease, caracterized by local suppuration and an extensive fibroinflammatory process, with a possible pseudotumoral outcome. AIM: To report a new observation of a pulmonary actinomycosis. CASE REPORT: A 52-year-old patient, smoker, admitted in our department for infectious pneumopathy complicated by purulent pleurisy. Clinical and radiological findings were not contributive.Fiberoptic had evocate the diagnosis of bronchopulmonary cancer. Evolution had been marqued by abondant hemoptysia indicating right low lobectomie. The diagnosis of actinomycosis was obtained by the pathology of the surgical resection. CONCLUSION: Diagnosis of pulmonary actinomycosis can be difficult because it can mimic the presentation of lung carcinoma.If the diagnosis is no late established, and if the patient is correctely treated medically, the prognosis still excellent.

[Thoracic manifestations of systemic lupus erythematosus]. / Manifestations thoraciques du lupus érythémateux systémique.

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease. The respiratory system is more commonly involved in SLE than in any other collagen vascular disease. AIM: To study the pleuropulmonary manifestations of SLE. METHODS: Retrospective study including 10 patients hospitalized between January 2000 and December 2008 for pleuro-pulmonary manifestation revealing or complicating the SLE. RESULTS: Nine women and only one man aged between 21 and 67 years-old were included in this study. Two patients had already SLE and for the other patients the pleuro-pulmonary manifestations were revealing the SLE. Pleural effusion was the most common manifestation witch represents 50% of the patients. For the other patients we find one case of interstitial pneumonia, one case of pulmonary embolism, on case of pneumonia, on case of pulmonary haemorrhage and on case of pulmonary hypertension. All these patients were treated by corticoids and only one patient takes high doses of corticoids for managing a massive pulmonary haemorrhage. The evolution was favourable for 9 patients, one patient dead because of massive pulmonary haemorrhage complicated with acute respiratory failure. CONCLUSION: Pleuro-pulmonary involvement in SLE is common and may be life threatening, in which case prompt and aggressive treatment is mandatory.