Severe Acute Pancreatitis Associated with Weil's Disease.

Leptospirosis is an emerging zoonosis of worldwide importance. Its distribution is closely linked to hydrometric conditions. It is characterized by a wide clinical range, from the subclinical form, or one with few symptoms; which resolves spontaneously, to the multi-visceral form, known as icterrohemorrhagic disease or Weil's disease, with a lethal risk. All organs can be affected but with variable frequency. Pancreatic involvement is not well documented. We describe a 45-year-old man with Weil's disease associated with acute necrotizing pancreatitis. The evolution was favorable but required a three-week stay in the intensive care unit.

[A case of acute renal failure revealing brucellian endocarditis and neurological complications in Batna (Algeria)]. / Un cas d'insuffisance rénale aiguë révélant une endocardite brucellienne et des complications neurologiques à Batna (Algérie).

Introduction: Brucellosis is a major zoonosis affecting livestock and transmitted to humans; it is widespread worldwide with 500,000 new cases per year according to the World Health Organization. It has become rare in countries that have established an eradication policy of the disease in animals and pasteurization of milk, but remains endemo-epidemic in Algeria, where it constitutes a public health problem (incidence of 24.41 per 100,000 inhabitants in 2017). The disease is more crippling than fatal. Severe forms are exceptional, and deaths are rare, most often following endocarditis or complicated neurological damage. The biological diagnosis is made by culturing the samples (mainly blood cultures), serology or molecular biology methods. We report the case of a patient with complicated and fatal subacute multiorgan brucellosis. Observation: A 51-year-old man is hospitalized in cardiology for endocarditis, complicated by neurovascular and skin manifestations, discovered in the stage of severe renal failure, one of the dreaded autoimmune complications of infectious endocarditis. The diagnoses were confirmed by various radiographic (echocardiography, brain computed tomography, magnetic resonance imaging) and biological examinations. The brucellian etiology was proved by bacteriological test of blood cultures (Brucella melitensis) and Wright's serodiagnosis, in the absence of the Polymerase Chain Reaction (PCR) test. Conclusion: Brucellosis can have atypical, multiple, varied and misleading presentations, responsible for a difficult clinical diagnosis. The possibly fatal evolution of this pathology should remind practitioners to evoke it, in particular in front of a multivisceral infectious presentation, in a country where brucellosis is endemic. Clinicians must also act quickly and not hesitate to ask for at least a serological test.

Epidemiological and Clinical Factors Associated with Spontaneous Clearance of Hepatitis C Virus.

BACKGROUND The risk of chronicity is high after acute hepatitis C. The infection remains limited and spontaneously resolves in an average of 30% of subjects. Such subjects are considered recovered and do not require any medical care. This study aims to evaluate the epidemiological and clinical factors associated with spontaneous viral clearance. METHODS We conducted a descriptive retrospective study on patients' files managed for a positive hepatitis C serology who benefited from the research of serum viral RNA by molecular biology. RESULTS The study collected 429 usable files. The mean age of the patients was 50.21 years, and the sex ratio was 0.98. Spontaneous viral clearance was estimated at 17.2%. The univariate analysis showed that clearance was significantly greater in subjects under the age of 50 years, patients without type 2 diabetes, patients co-infected with hepatitis B virus, patients with transfusion, and those diagnosed fortuitously. Multivariate analysis confirmed the relationship between diabetes and the circumstances of the diagnosis. The relationship in the case of hepatitis B co-infection was very close to the statistical significance level (p=0.055). CONCLUSION The presence of hepatitis B co-infection in patients with positive hepatitis C serology predicts a high probability of having spontaneous clearance. However, advanced age and the existence of a history of blood transfusion, type 2 diabetes or suggestive signs of liver damage are associated with persistent viremia.

First study of hepatitis delta virus in Algeria: Seroprevalence and risk factors in Setif region (east of Algeria).

BACKGROUND: No recent data are available on hepatitis delta virus (HDV) prevalence in Algeria. For this reason we conducted an epidemiological study, cross-sectional seroprevalence of HDV in the region of Setif. METHODS: Between 2011 and 2014, sera samples of 500 patients (carrying HBsAg) admitted to the Division of Infectious Diseases Teaching Hospital, Setif (east of Algeria), were tested for anti-HDV-IgG ab (ETI-AB-DeltaK-2). RESULTS: The prevalence of HDV obtained is estimated at 2.4%. The prevalence ranges from 1% in chronic hepatitis to 11.1% in cirrhotic hepatitis (low endemic area). Seropositivity rate is closely correlated with age (Odds ratio [OR] = 9.98, p = 0.000) and gender (OR = 0.24, p = 0.025); it reaches 58.3% in the age group of 51-60 years and 0% in children (age group 1-15 years); it represents 75% in females and 25% in males. The presence of familial cases of HBsAg positive (OR = 4.54, p = 0.006), the endoscopic procedure (OR = 6.54, p = 0.000) and tattooing (OR = 20, p = 0.000) were found to be the transmission risk factors. A statistically significant relationship was found between the positivity of anti-HDV and advanced liver disease, cirrhosis (OR = 9. 16, p = 0.000). A significant correlation was found between the positivity of anti-HDV with diabetes (OR = 6.83, p = 0.000), obesity (OR = 4.19, p = 0.009) and viral suppression B (OR = 5.69, p = 0.003). CONCLUSION: Our results show that HDV infection is low in Algeria. Research for total anti-HDV should be part of the initial assessment of patient care with viral hepatitis B as well as the prevalence of other viruses (hepatitis C [HCV] and HIV). A multicentre study should be carried out to know the importance of HDV infection and identify the risk groups.