[Neurobrucellosis: description of 5 cases in Setif Hospital, Algeria]. / Neurobrucellose: 5 observations à l'hôpital de Sétif, Algérie.

PURPOSE: Brucellosis is a major ubiquitous zoonosis transmitted from livestock to humans. It is a public health problem in developing countries. Between 2003 and 2005, the incidence of brucellosis in Algeria showed a 181% increase from 8.79 to 24.71. Between 2005 and 2007, the incidence remained almost stable. The estimated mean incidence of neurobrucellosis is 4% with clinical manifestations that are variable and often multi-focal in the same patient. The purpose of this retrospective study is to describe 5 cases of neurobrucellosis managed in our department between 2001 and 2007. MATERIALS AND METHODS: It was a retrospective study 5 patients. There were 2 women and 3 men with a mean age of 20 years. RESULTS: Neurological involvement occurred immediately in all patients. Clinical manifestations were variable with meningoencephalitis in 2, meningoencephalitis associated with a polyperipheral neuropathy in 1, meningomyeloradiculitis in 1, and acute diffuse encephalitis in 1. Definitive diagnosis was based on isolation of bacteria from a blood specimen in 1 case and detection of antibodies in blood and cerebrospinal fluid in 4. All patients were treated using a combination of 3 of the following 4 drugs: doxycycline, rifampicine, cotrimoxazole and aminoside. Treatment was associated with corticosteroid therapy in 3 cases. DISCUSSION: Neurobrucellosis can affect any part of the nervous system and can mimic any neurological disease. Early detection and treatment is the only predictor of favorable outcome of neurobrucellosis, but there is no standardized treatment protocol. Neurobrucellosis should be included in differential diagnosis for any patient presenting central or peripheral neurological manifestations especially in endemic zones.

Fulminant viral hepatitis and pregnancy in Algeria and France.

The relationship between fulminant viral hepatitis (FVH) and pregnancy was compared in Algeria and France. This comparison was based on the study of 22 Algerian and 77 French pregnant and non-pregnant women, aged 15 to 49 years, consecutively admitted for FVH to the Centre Hospitalier Universitaire, Constantine, Algeria, or to Hôpital Beaujon, Clichy, France. The observed and expected (calculated from demographic data) percentage of pregnant women was significantly different among the Algerian patients with FVH (45.5% v. 24.9%, P less than 0.03), but not among the French patients (3.9% v. 5.8%). Hepatitis A was the cause of FVH in none of the Algerian patients, but in eight French patients, none of whom was pregnant. Hepatitis B was the cause of FVH in one non-pregnant Algerian patient and in 49 French patients, two of whom (4.1%) were pregnant. Hepatitis non-A, non-B was the cause of FVH in 21 Algerian patients, ten of whom (47.6%, a percentage significantly higher than expected, P less than 0.04) were pregnant, and in 19 French patients, one of whom (5.3%, a percentage similar to that expected) was pregnant. In conclusion, (1) there is a relationship between FVH and pregnancy in Algeria, but not in France, and (2) this difference is mainly or exclusively attributable to infection with a non-A, non-B virus affecting the Algerian population, but which is much less common or absent in France.