[Current aspects of neuromeningeal cryptococcosis in adults infected with HIV in the internal medicine service of the University Hospital of Treichville Abidjan (Cote d'Ivoire)]. / Aspects actuels de la cryptococcose neuroméningée chez des sujets adultes infectés par le VIH dans le service de médecine interne du CHU de Treichville d'Abidjan (Côte d'Ivoire).

OBJECTIVES: To determine the prevalence of neuromeningeal cryptococcosis (NMC) and reporting sociodemographic, clinical, paraclinical aspects and outcome of patients. METHODS: It was a retrospective study concerning 22 HIV positive patients hospitalized between 2006 to and 2009 in the internal medicine service of University Hospital of Treichville for NMC. RESULTS: The prevalence of NMC in patients infected with HIV was 0.6%. The mean age was 35±4.5 years old. The sex-ratio was 0.5. The average time evolution of the symptomatology was 10±2.1 days. The installation of the disease was progressive (86.4%). The main signs were fever (100%) and headache (95.4%). The cerebrospinal fluid was inflammatory aspect (95.4%) with low glucose (91%), hyper lymphocytosis(100%). There were Cryptococcus neoformans in direct exam by China ink (72.7%) and culture on Sabouraud (100%). Treatment was injectable amphoterin B in monotherapy (54.5%) followed by fluconazole per os (45.5%). The mortality was 54.5%. CONCLUSION: This study shows a reduction of NMC prevalence in our service in relation with tritherapy.

[Histoplasma capsulatum histoplasmosis: apropos of 1 case observed in the internal medicine department of the CHU of Treichville (Abidjan)]. / Histoplasmose à Histoplasma capsulatum: à propos d'un cas observé dans le service de médecine interne du CHU de Treichville (Abidjan).

The advent of AIDS has resulted in an increase in diseases which were previously rare. In HIV-infected subjects, histoplasmosis takes a disseminated and particularly severe form, with a fatal outcome in our country, the more so because the clinical presentation resembles tuberculosis and is generally treated as such. The authors report a case of disseminated histoplasmosis in a patient dually-reactive to HIV-1 and HIV-2, in whom the clinical presentation was fever, mediastinal lymphadenopathy and pulmonary infiltrates. The diagnosis of histoplasmosis was made at autopsy.

[Pain during peritoneum pinching, a pathognomonic sign of peritoneal disease. Clinical research. Semiological value]. / La douleur au pincement du péritoine, signe pathognomonique d'affection péritonéale. Recherche clinique. Valeur séméiologique.

Pain induced by pinching the peritoneum betrays a pathology of that membrane. It is absent when the peritoneum is perfectly healthy. Pain is elicited by a special palpation technique. Clinically and statistically, the presence of this pain is pathognomonic, but it does not inform on the aetiology. In the present study the most frequent causes of positive abdominal peritoneal pinching test were peritoneal tuberculosis, followed by portal hypertension with or without liver cirrhosis.

[Stopping persistent hiccups in the adult by endoscopic maneuver]. / Arrêt du hoquet persistant de l'adulte par manoeuvres endoscopiques.

Thirty-four patients with persistent hiccups (median duration 10 days) were treated by gentle endoscopic massage of the region of the cardia. Hiccups stopped in all cases. Its early recurrence in one patient only required a second massage, which was also effective. This simple technique is recommended for the treatment of persistent hiccups.

[HIV1 seropositivity and B and D viruses in West Africa]. / Séropositivité VIH1, virus B et D en Afrique de l'Ouest.

This study was undertaken to investigate relationships between three widespread viruses in West Africa, i.e. HIV1 and viruses B and D, in Ivory Coast. Serologic tests for viruses B and D were carried out in a random sample of black adults of both sexes with asymptomatic HIV1 seropositivity. Coinfection by virus B or viruses B and D was a common finding. Coinfection with both viruses B and D, but not with virus B alone, was found to be significantly more frequent in these HIV1-infected adults than in a control group with acute viral hepatitis. Potential interactions between the HIV1 and viruses B and D as well as other viruses are discussed. These findings suggest that one or several cofactors acting alone or in combination play a major role in the clinical expression of HIV infection. The results of this study, together with the suggestion put forward by several investigators that B virus infection may increase the severity of AIDS, are evidence in support of the value of immunization against the B virus in the management of AIDS.