Spontaneous rupture of a giant pyonephrosis: A case report.

Pyonephrosis is a suppurative infection of the kidney caused by ureteral obstruction. It can lead to kidney failure, septic shock, and death. Thus, it requires prompt assessment and appropriate management. We report a case of a 63-year-old male with giant pyonephrosis contained 10 liters of pus and spontaneously ruptured in the adjacent muscles. This clinical case illustrates the value of computed tomography scan in the diagnosis and management of an uncommon upper urinary tract infection and its complications.

[Feasibility and relevance of safety checklist in the central operating block at the Regional Medical Center, Saint Louis, Senegal]. / Faisabilité et pertinence de la check-list de sécurité au bloc opératoire central du Centre Hospitalier Régional de Saint Louis du Sénégal.

INTRODUCTION: Safety checklist (CL) in the operating block is a quality tool which allows to reduce perioperative morbidity and mortality. That is one of the French National Health Authority requirements for the certification procedure of healthcare institutions. This study aimed to conduct a quantitative and qualitative evaluation of the use of this tool in the central operating block at the Regional Medical Center in Saint Louis. METHODS: A prospective evaluation of the indicators for monitoring the practical use of the checklist and the contribution to the improvement of surgical practices in the operating block at the Regional Medical Center in Saint Louis was initiated since the launch of this study in March 2016. RESULTS: CL utilization rate was 75%, compliance rate was 60%; information rate was 99% for the pre-induction items, 93% for the pre-incision items and 88% for the postoperative items. Only 73% of analyzed CL were filled with an effective oral communication according to the three items. CL helped to detect hardware failures and/or adverse events in 15% of cases. No patient's identification or operated side error were objectified in our study. CONCLUSION: CL contributes in the development of the culture of patient's safety in the operating block and has led to the establishment of a risk mapping in the operating block. Nevertheless, while important, it shouldn't be considered a magic tool to avoid errors but integrated into the improvement in health care quality with other programs such as the reporting of adverse events and the the review of morbidity and mortality.

Urinary tract infection with Corynebacterium aurimucosum after urethroplasty stricture of the urethra: a case report.

INTRODUCTION: Corynebacteria have an important place among the commensal flora of the skin and mucous membranes. Except for Corynebacterium diphtheriae, they were once considered contaminants of mucosa. Recent publications in medical bacteriology have highlighted the importance of several species, such as C. aurimucosum. To the best of our knowledge, we report the first isolation of this strain from urine. CASE PRESENTATION: We report a case of a patient with a urinary tract infection with C. aurimucosum. We isolated this bacterium from a 52-year-old man of Wolof ethniticity (an ethnic group in Senegal, West Africa) at the regional hospital of Saint Louis, Senegal. Microscopic examination of his total urine sample showed coryneform Gram-positive bacilli associated with a high leukocyte reaction. After repeated isolation of the corynebacteria in three samples from the patient's urine, it was identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. The strain was susceptible to antibiotics, except for penicillin and co-trimoxazole. The potential infectious role of these commensal species in several infections should be taken into consideration. CONCLUSIONS: This case highlights the significant proportion of species in the genus Corynebacterium other than dyphteriae in the infectious process. The use of mass spectrometry for identification highlights the originality of this work and the importance of these new diagnostic tools that are unavailable in most health facilities of countries with limited resources. We share the results of our method of identification of the isolated bacteria. This case should prompt attention to these rare bacteria, which can cause severe infections.