[Bessef Hogen's disease, or exostosis disease, with spinal cord compression: a case in the service of the Paediatric CHU Ouedraogo, Ouagadougou, BF]

CA, 14 old years, female, born last uterine siblings of 9 children, 4 died of various causes, was admitted in the pediatric service of CHU-YO for functional impairment of the lower limbs. Physical examination revealed swelling and deformation harsh, uneven surfaces, the circumferential upper and lower limbs and lumbar spine associated with spastic paraplegia. Sphincter disturbances accompany this clinical picture. The radiographic bone marrow hypertrophy individually with images of exostosis at the epiphyses. Multiple exostosis or BESSEF Hogen's disease is rare and has a reserve functional prognosis because of outcome of low spinal cord compression and vascular compression. We felt it appropriate to bring this case discovered during our clinical practice because of its rarity and the risk of malignant degeneration.

Mycobacterium tuberculosis drug-resistance in previously treated patients in Ouagadougou, Burkina Faso

BACKGROUND

Tuberculosis drug-resistance becomes common in sub-Saharan Africa; however, very few data are available in Burkina Faso. The aim of this study is to assess the acquired resistance of Mycobacterium tuberculosis complex strains identified in TB patients to four first-line drugs in Ouagadougou.

METHODS

One hundred and ten (110) pulmonary tuberculosis patients with acid-fast bacilli-positive sputum and in situation of failure, relapse, or treatment abandonment were included in the study. Ninety six strains, including 92 (95.8%) M. tuberculosis and 4 (4.2%) M. africanum, were isolated from the sputum samples of these patients. Their drug susceptibility testing was performed using the proportion method. The first-line drugs tested were isoniazid (INH), streptomycin (STR), ethambutol (EMB), and rifampicin (RIF).

RESULTS

The overall drug-resistance rate of M. tuberculosis was 67.4% (n=60), including 3.4% to one drug, 18% to two, 10.1% to three, and 35.9% to four drugs. The resistance to INH, RIF, EMB, and STR were 67.4%, 51.7%, 50.6%, and 44.9%, respectively. Two strains of M. africanum were resistant to all drugs. Forty-six (51.7%) strains were multidrug-resistant (resistant to at least INH and RIF).

CONCLUSIONS

In previously treated patients, the level of resistance of M. tuberculosis complex to commonly used anti-tuberculosis drugs is very high in Ouagadougou. Our results showed that multidrug-resistant tuberculosis could be a public health problem in Burkina Faso.