[88 years of cutaneous leishmaniasis in Morocco]. / Quatre-vingt-huit années de leishmaniose cutanée au Maroc.

Leishmaniasis in its cutaneous form is a public health problem in Morocco. The objectives of this study were to assess the development of its epidemiological profile, identify the relevant species, and determine the location of the identified cases and their distribution by year, by sex, and by age. This retrospective epidemiological study covers a period of 88 years and concerns all reported cases of cutaneous leishmaniasis (CL) in Morocco from the first description in 1922 until 2010. During this period, 56,194 cases have been reported; they account for 95.7% of all cases of leishmaniasis (n = 58,710). The endemicity of CL has changed over time. The increase in its incidence is likely to be explained both by improved reporting and by a real increase in the number of cases.

[Candida albicans endocarditis after treatment of complete atrioventricular canal]. / Endocardite à Candida albicans après cure de canal atrioventriculaire complet.

Infective endocarditis is rare in children, it is rarer after a surgical treatment of atrioventricular canal, and it is exceptional that Candida albicans is the etiologic agent. This is a serious infection found in congenital heart disease with or without surgery. It is potentially lethal, despite diagnostic and therapeutic advances. We report a case of infective endocarditis due to C. albicans after the treatment of a congenital systemic atrioventricular canal in a child with trisomy 21. The diagnosis was suspected on clinical manifestations and cardiac auscultation. Confirmation was provided by positive blood cultures and echocardiography. The large size of the vegetation in the patient was in favor of a fungal etiology, blood cultures allowed to identify the fungus. This observation illustrates a poorly understood disease, with very poor prognosis and which is a potential complication of heart surgery. The improved prognosis should be achieved by shortening the time to diagnosis and optimizing the therapeutic support.

Usefulness of gram staining of blood collected from total parenteral nutrition catheter for rapid diagnosis of catheter-related sepsis.

The accuracy of Gram staining of blood drawn from catheters used to administer total parenteral nutrition was compared with paired quantitative blood cultures for the diagnosis of catheter-related sepsis. Gram staining was positive in 11 of 18 episodes of catheter-related sepsis documented by quantitative culture (sensitivity, 61%) but in none of the 5 episodes of fever unrelated to catheter infection. Thus, this procedure enabled the rapid presumptive diagnosis and guidance of antimicrobial therapy for total parenteral nutrition catheter sepsis, with a positive predictive value of 100% and a negative predictive value of 42%.

Endoscopic varix ligation: a promising new technique?

Endoscopic varix ligation is a new promising endoscopic method which compete with endoscopic sclerotherapy both during acute bleeding and the chronic setting where the aim is to obliterate varices as soon as possible with minimal side effects.