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Ayari R, Chaouch H, Findlay-Wilson S, Hachfi W, Ben Lasfar N, Bellazreg F, Dowall S, Hannachi N, Letaief A. Seroprevalence and Risk Factors Associated with Phleboviruses and Crimean-Congo Hemorrhagic Fever Virus among Blood Donors in Central Tunisia. Pathogens 2024; 13:348. [PMID: 38668303 PMCID: PMC11054088 DOI: 10.3390/pathogens13040348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/15/2024] [Accepted: 04/19/2024] [Indexed: 04/29/2024] Open
Abstract
The aim of this study was to determine the prevalence of six viruses, from two families of the order Bunyavirales, in the general population of central Tunisia. Sera collected from 377 asymptomatic blood donors were serologically assayed for Rift Valley fever virus (RVFV), Crimean-Congo hemorrhagic fever virus (CCHFV), and four sandfly-borne phleboviruses: Toscana virus (TOSV), sandfly fever Naples virus (SFNV), sandfly fever Sicilian virus (SFSV), and sandfly fever Cyprus virus (SFCV). Of the 377 subjects enrolled in this study, 17.3% were IgG positive for at least one of the viruses tested. The most frequently detected antibodies were against TOSV (13.3%), followed by SFCV (2.9%), RVFV (1.9%), SFSV (1.3%), and SFNV (1.1%). Only one sample was IgG positive for CCHFV. Dual reactivity was observed in nine cases: SFSV + SFCV in three cases (0.8%) and TOSV + SFNV, TOSV + SFCV, and TOSV + RVFV in two cases (0.5%) each. 15.9% of donors were IgG positive against sandfly-borne phleboviruses. Among the 65 donors IgG positive for phleboviruses, 50.8% were from rural areas compared to 12.3% from urban areas (p < 0.001); 92.3% had animals in their living quarters (p = 0.009); and 70.8% lived in the vicinity of stagnant water (p = 0.062). Seroprevalence was significantly higher among donors living with chronic diseases (p = 0.039). Furthermore, the seroprevalence of phleboviruses was higher in Kairouan, the central governorate, than in the two coastal governorates: Monastir and Sousse, with 33.4%, 24.2%, and 14.9%, respectively. The presence of antibodies in the general population needs further investigation to better assess the extent of these viruses. Only TOSV was known to have an extensive circulation in Tunisia and in North Africa. Continued surveillance and interventions are necessary to detect the emergence of all arboviruses and to prevent further transmission.
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Affiliation(s)
- Rym Ayari
- Infectious Diseases Department, Farhat Hached University Hospital, Sousse 4000, Tunisia; (R.A.); (H.C.); (W.H.); (N.B.L.); (F.B.)
| | - Houda Chaouch
- Infectious Diseases Department, Farhat Hached University Hospital, Sousse 4000, Tunisia; (R.A.); (H.C.); (W.H.); (N.B.L.); (F.B.)
| | - Stephen Findlay-Wilson
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (S.F.-W.); (S.D.)
| | - Wissem Hachfi
- Infectious Diseases Department, Farhat Hached University Hospital, Sousse 4000, Tunisia; (R.A.); (H.C.); (W.H.); (N.B.L.); (F.B.)
- Faculty of Medicine, University of Sousse, Sousse 4000, Tunisia;
| | - Nadia Ben Lasfar
- Infectious Diseases Department, Farhat Hached University Hospital, Sousse 4000, Tunisia; (R.A.); (H.C.); (W.H.); (N.B.L.); (F.B.)
- Faculty of Medicine, University of Sousse, Sousse 4000, Tunisia;
| | - Foued Bellazreg
- Infectious Diseases Department, Farhat Hached University Hospital, Sousse 4000, Tunisia; (R.A.); (H.C.); (W.H.); (N.B.L.); (F.B.)
- Faculty of Medicine, University of Sousse, Sousse 4000, Tunisia;
| | - Stuart Dowall
- UK Health Security Agency (UKHSA), Porton Down, Salisbury SP4 0JG, UK; (S.F.-W.); (S.D.)
| | - Neila Hannachi
- Faculty of Medicine, University of Sousse, Sousse 4000, Tunisia;
- Microbiology Laboratory, Farhat Hached University Hospital, Sousse 4000, Tunisia
| | - Amel Letaief
- Infectious Diseases Department, Farhat Hached University Hospital, Sousse 4000, Tunisia; (R.A.); (H.C.); (W.H.); (N.B.L.); (F.B.)
- Faculty of Medicine, University of Sousse, Sousse 4000, Tunisia;
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Ach T, Ben Haj Slama N, Gorchane A, Ben Abdelkrim A, Garma M, Ben Lasfar N, Bellazreg F, Debbabi W, Hachfi W, Chadli Chaieb M, Zaouali M, Letaief A, Ach K. Explaining Long COVID: A Pioneer Cross-Sectional Study Supporting the Endocrine Hypothesis. J Endocr Soc 2024; 8:bvae003. [PMID: 38260089 PMCID: PMC10801829 DOI: 10.1210/jendso/bvae003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Indexed: 01/24/2024] Open
Abstract
Context In some patients, symptoms may persist after COVID-19, defined as long COVID. Its pathogenesis is still debated and many hypotheses have been raised. Objective Our primary objective was to evaluate the corticotroph and somatotroph functions of patients previously infected with SARS-CoV-2 and experiencing post-COVID-19 syndrome to detect any deficiencies that may explain long COVID. Methods A cross-sectional study was conducted including patients who had previously contracted SARS-CoV-2 with a postinfection period of 3 months or less to 15 months, divided into 2 groups. The first group (G1) comprised fully recovered patients, while the second group (G2) included patients experiencing long COVID. The primary outcome was the comparison of corticotroph and somatotroph functions. Results A total of 64 patients were divided into 2 groups, each consisting of 32 patients. G2 exhibited more frequently anterior pituitary deficits compared to G1 (P = .045): for the corticotroph axis (G1: 6.3% vs G2: 28.1%) and for the somatotroph axis (G1: 31.3% vs G2: 59.4%). Baseline cortisol level was significantly lower in G2 (G1: 13.37 µg/dL vs G2: 11.59 µg/dL) (P = .045). The peak cortisol level was also lower in G2 (G1: 23.60 µg/dL vs G2: 19.14 µg/dL) (P = .01). For the somatotroph axis, the insulin growth factor-1 level was lower in G2 (G1: 146.03 ng/mL vs G2: 132.25 ng/mL) (P = .369). The peak growth hormone level was also lower in G2 (G1: 4.82 ng/mL vs G2: 2.89 ng/mL) (P = .041). Conclusion The results showed that long COVID patients in our cohort were more likely to have anterior pituitary deficiencies. The endocrine hypothesis involving anterior pituitary insufficiency can be considered to explain long COVID.
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Affiliation(s)
- Taieb Ach
- Department of Endocrinology, University Hospital of Farhat Hached, Sousse 4000, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Laboratory of Exercise Physiology and Pathophysiology, L.R. 19ES09, Sousse 4000, Tunisia
| | - Nassim Ben Haj Slama
- Department of Endocrinology, University Hospital of Farhat Hached, Sousse 4000, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
| | - Asma Gorchane
- Department of Endocrinology, University Hospital of Farhat Hached, Sousse 4000, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
| | - Asma Ben Abdelkrim
- Department of Endocrinology, University Hospital of Farhat Hached, Sousse 4000, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
| | - Meriem Garma
- University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
- Infectious Diseases Department, Farhat Hached Hospital, Sousse 4000, Tunisia
| | - Nadia Ben Lasfar
- University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
- Infectious Diseases Department, Farhat Hached Hospital, Sousse 4000, Tunisia
| | - Foued Bellazreg
- University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
- Infectious Diseases Department, Farhat Hached Hospital, Sousse 4000, Tunisia
| | - Widéd Debbabi
- University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
- Department of Endocrinology, University Hospital of Ibn El Jazzar, Kairouan 4041, Tunisia
| | - Wissem Hachfi
- University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
- Infectious Diseases Department, Farhat Hached Hospital, Sousse 4000, Tunisia
| | - Molka Chadli Chaieb
- Department of Endocrinology, University Hospital of Farhat Hached, Sousse 4000, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
| | - Monia Zaouali
- Department of Endocrinology, University Hospital of Farhat Hached, Sousse 4000, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Laboratory of Exercise Physiology and Pathophysiology, L.R. 19ES09, Sousse 4000, Tunisia
| | - Amel Letaief
- University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
- Infectious Diseases Department, Farhat Hached Hospital, Sousse 4000, Tunisia
| | - Koussay Ach
- Department of Endocrinology, University Hospital of Farhat Hached, Sousse 4000, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, Sousse 4000, Tunisia
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Toumi A, Ben Brahim H, Berriche A, Hachfi W, Marrakchi C, Ammari L, Ben Lasfar N, Koubaa M, Aoun K, Neji S, Ben Abdallah R, Bouchekoua M, Mhalla S, Naïja H, Gargouri S, Hannachi N, Thabet L, Mnif B, Achour W, Marzouk M, Boutiba I, Chippaux JP. [32nd National STPI Congress 2nd French-speaking Congress of Infectious Pathology and Clinical Microbiology 5 to 7 May 2023, Hammamet, Tunisia]. Med Trop Sante Int 2023; 3:mtsi.v3i4.2023.432. [PMID: 38390017 PMCID: PMC10879895 DOI: 10.48327/mtsi.v3i4.2023.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 06/08/2023] [Indexed: 02/24/2024]
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Bellazreg F, Ben Lasfar N, Abid M, Rouis S, Hachfi W, Letaief A. Antibiotic stewardship team in a Tunisian university hospital: A four-year experience. Tunis Med 2022; 100:403-409. [PMID: 36206090 PMCID: PMC9552246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Association between antibiotic use and antimicrobial resistance has been demonstrated in several studies; hence the importance of antibiotic stewardship programs (ASPs) to reduce the burden of this resistance. AIM To describe the antibiotic stewardship team (AST) interventions in a Tunisian university hospital. METHODS a cross-sectional study was conducted in the infectious diseases department in Sousse-Tunisia between 2016 and 2020. Hospital and private practice doctors have been informed of the existence of an antibiotic stewardship team. Interventions consisted of some helps to antibiotic therapy (i.e.; prescription, change or discontinuation) and/or diagnosis (i.e.; further investigations). RESULTS Two thousand five hundred and fourteen interventions were made including 2288 (91%) in hospitalized patients, 2152 (86%) in university hospitals and 1684 (67%) in medical wards. The most common intervention consisted of help to antibiotic therapy (80%). The main sites of infections were skin and soft tissues (28%) and urinary tract (14%). Infections were microbiologically documented in 36% of cases. The most frequently isolated microorganisms were Enterobactriaceae (41%). Antibiotic use restriction was made in 44% of cases including further investigations (16%), antibiotic de-escalation (11%), no antibiotic prescription (9%) and antibiotic discontinuation (8%). In cases where antibiotics have been changed (N=475), the intervention was associated with an overall decrease in the prescription of broad-spectrum antibiotics from 61% to 50% with a decrease in the prescription of third generation cephalosporins from 22% to 15%. CONCLUSIONS The majority of antibiotic stewardship team's interventions were made in hospitalized patients, university hospitals and medical wards. These interventions resulted in an overall and broad-spectrum antibiotic use reduction.
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Bellazreg F, Slama D, Ben Lasfar N, Abid M, Zaghouani H, Rouis S, Hachfi W, Letaief A. Neurological manifestations following cured malaria: don't forget post-malaria neurological syndrome. Afr Health Sci 2021; 21:273-276. [PMID: 34394307 PMCID: PMC8356585 DOI: 10.4314/ahs.v21i1.35] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction Cerebral malaria which occurs during the active infection is the most common neurological complication of malaria. Other complications including post-malaria neurological syndrome (PMNS) can rarely occur following complete recovery from the disease. We report a case of post-malaria neurological syndrome in a Tunisian patient. Case presentation A 26-year-old Tunisian man with no past medical history was admitted in 2016 for a muscle weakness of the 4 limbs, seizures, tetraparesis and myoclonus which appeared after he returned from Côte d'Ivoire where he had been treated three weeks ago for Plasmodium falciparum malaria with favorable outcome. Blood smears for malaria were negative. Brain MRI showed multiple hypersignal cerebral lesions. Investigations didn't show any infectious, metabolic, toxic, vascular or tumoral etiology. Thus, the diagnosis of PMNS was considered. The patient was treated with methylprednisolone with favorable outcome. Two years later, he was completely asymptomatic. Conclusion PMNS should be considered in patients with neurological symptoms occurring within two months of cured acute disease in which blood smears for malaria are negative and other etiologies have been ruled out. In most cases, the disease is self-limited while in severe cases corticosteroid therapy should be prescribed with favorable outcome.
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Abid M, Ben Abdessalem MA, Elmenif K, Fekih RA, Ben Lasfar N, Bouhlel I, Bellazreg F, Hachfi W, Jeridi G, Mahdhaoui A, Letaief A. Sinus bradycardia: an unusual manifestation of mild to moderate COVID-19 pneumonia. Tunis Med 2020; 98:886-887. [PMID: 33479989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
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Hachfi W, Ben Lasfar N. COVID-19: Main therapeutic options. Tunis Med 2020; 98:299-303. [PMID: 32395792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Chakroun H, Ben Lasfar N, Fall S, Maha A, El Moussi A, Abid S, Rouis S, Bellazreg F, Abassi-Bakir D, Bouafif Ben Alaya N, Boutiba Ben Boubaker I, Hachfi W, Letaief A. First case of imported and confirmed COVID-19 in Tunisia. Tunis Med 2020; 98:258-260. [PMID: 32395787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Bellazreg F, Abid M, Lasfar NB, Hattab Z, Hachfi W, Letaief A. Diagnostic value of dipstick test in adult symptomatic urinary tract infections: results of a cross-sectional Tunisian study. Pan Afr Med J 2019; 33:131. [PMID: 31558930 PMCID: PMC6754830 DOI: 10.11604/pamj.2019.33.131.17190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 04/14/2019] [Indexed: 11/11/2022] Open
Abstract
Urinary tract infections (UTIs) are common. The diagnosis is confirmed by urine culture which is costly and takes at least 24 hours before results are known. The aim of this study was to determine the diagnostic accuracy of dipstick test for the diagnosis of UTI in symptomatic adult patients. We conducted a cross-sectional study in the department of Infectious Diseases, Sousse-Tunisia during a two-year period. We included all patients with clinical signs of UTI. Urine samples were tested for the presence of leukocyte esterase (LE) and nitrites. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of LE and nitrites were calculated against urine culture as gold standard. Four hundred thirty one patients, 139 men (32%) and 292 women (68%) were included. One hundred sixty six patients (39%) had UTI. The most frequently isolated microorganism was Escherichia coli (75%). LE had a high sensitivity (87%) but a low specificity (64%), while nitrites had a high specificity (95%) but a low sensitivity (48%). Combined positive LE and nitrites had a high PPV (85%) and combined negative LE and nitrites had a high NPV (92%), while positive LE combined with negative nitrites had a low PPV (47%) and a low NPV (53%). In conclusion, in adult patients with UTI symptoms, an alternate diagnosis should be considered if the LE is negative, while an early empirical antibiotic therapy against Enterobacteriaceae should be started if the nitrites are positive.
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Affiliation(s)
- Foued Bellazreg
- Department of Infectious Diseases, Farhat Hached Hospital, Sousse, Tunisia
| | - Maha Abid
- Department of Infectious Diseases, Farhat Hached Hospital, Sousse, Tunisia
| | - Nadia Ben Lasfar
- Department of Infectious Diseases, Farhat Hached Hospital, Sousse, Tunisia
| | - Zouhour Hattab
- Department of Infectious Diseases, Farhat Hached Hospital, Sousse, Tunisia
| | - Wissem Hachfi
- Department of Infectious Diseases, Farhat Hached Hospital, Sousse, Tunisia
| | - Amel Letaief
- Department of Infectious Diseases, Farhat Hached Hospital, Sousse, Tunisia
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Chelli J, Bellazreg F, Aouem A, Hattab Z, Mesmia H, Lasfar NB, Hachfi W, Masmoudi T, Chakroun M, Letaief A. [Causes of death in patients with HIV infection in two Tunisian medical centers]. Pan Afr Med J 2016; 25:105. [PMID: 28292068 PMCID: PMC5325519 DOI: 10.11604/pamj.2016.25.105.9748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/08/2016] [Indexed: 01/31/2023] Open
Abstract
La trithérapie antirétrovirale a contribué à une baisse considérable de la mortalité liée au VIH. Les causes de décès sont dominées par les infections opportunistes dans les pays en voie de développement et par les maladies cardiovasculaires et les cancers dans les pays développés. L’objectif était de déterminer les causes et les facteurs de risque de décès des patients infectés par le VIH dans le Centre Tunisien. Une étude transversale auprès des patients infectés par le VIH âgés de plus de 15 ans suivis à Sousse et à Monastir entre 2000 et 2014. Le décès était considéré lié au VIH si la cause était un évènement classant SIDA ou s’il était la conséquence d’une infection opportuniste d’étiologie indéterminée avec des CD4 < 50/mm3, non lié au VIH si la cause n’était pas un évènement classant SIDA, et de cause inconnue si aucune information n’était disponible. Deux cents treize patients, 130 hommes (61%) et 83 femmes (39%), d’âge moyen 40±11 ans ont été inclus. Cinquante quatre patients sont décédés, avec une mortalité de 5,4/100 patients-années. La mortalité annuelle a baissé de 5,8% en 2000-2003 à 2,3% en 2012-2014. La survie était de 72% à 5 ans et de 67% à 10 ans. Les décès étaient liés au VIH dans 70,4% des cas. Les causes de décès les plus fréquentes étaient la pneumocystose pulmonaire et la cryptococcose neuroméningée dans 6 cas (11%) chacune. Les facteurs de risque de décès étaient les antécédents d’infections opportunistes, la durée de la trithérapie antirétrovirale < 12 mois et le tabagisme. Le renforcement du dépistage, l’initiation précoce de la trithérapie antirétrovirale, et la lutte contre le tabagisme sont nécessaires afin de réduire la mortalité chez les patients infectés par le VIH en Tunisie.
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Affiliation(s)
- Jihène Chelli
- Service de Maladies Infectieuses, CHU Farhat Hached, Sousse 4000, Tunisie
| | - Foued Bellazreg
- Service de Maladies Infectieuses, CHU Farhat Hached, Sousse 4000, Tunisie
| | - Abir Aouem
- Service de Maladies Infectieuses, CHU Fattouma Bourguiba, Monastir 5000, Tunisie
| | - Zouhour Hattab
- Service de Maladies Infectieuses, CHU Farhat Hached, Sousse 4000, Tunisie
| | - Hèla Mesmia
- Service de Maladies Infectieuses, CHU Fattouma Bourguiba, Monastir 5000, Tunisie
| | - Nadia Ben Lasfar
- Service de Maladies Infectieuses, CHU Farhat Hached, Sousse 4000, Tunisie
| | - Wissem Hachfi
- Service de Maladies Infectieuses, CHU Farhat Hached, Sousse 4000, Tunisie
| | - Tasnim Masmoudi
- Service de Médecine Légale, CHU Farhat Hached, Sousse 4000, Tunisie
| | - Mohamed Chakroun
- Service de Maladies Infectieuses, CHU Fattouma Bourguiba, Monastir 5000, Tunisie
| | - Amel Letaief
- Service de Maladies Infectieuses, CHU Farhat Hached, Sousse 4000, Tunisie
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Bellazreg F, Alaya Z, Hattab Z, Lasfar NB, Ayeche MLB, Bouajina E, Letaief A, Hachfi W. [Infectious sacroiliitis in tunisian centre: retrospective study of 25 cases]. Pan Afr Med J 2016; 24:3. [PMID: 27583067 PMCID: PMC4992370 DOI: 10.11604/pamj.2016.24.3.8659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 04/03/2016] [Indexed: 12/02/2022] Open
Abstract
Infectious sacroiliitis are rare but they can be complicated by disabling functional sequelae. To describe the clinical and bacteriological characteristics of infectious sacroiliitis among patients treated in Sousse Medical Center, Tunisia. A retrospective, descriptive study, of infectious sacroiliitis among patients hositalized in Sousse between 2000 and 2015. The diagnosis was made on the basis of medical signs, imaging, microbiological indicators. In the study were enrolled twenty five patients, 10 men and 15 women; the average age was 41 years (19-78). Sacroiliitis were due to pyogenic bacteria in 14 cases (56%), brucella bacteria in 6 cases (24%) and tuberculosis bacteria in 5 cases (20%). The mean duration of symptoms was 61, 45 and 402 days respectively. The most common clinical signs were buttock pain (92%) and fever (88%). Standard radiographic evaluation was abnormal in 75% of cases. CT scan and MRI of the sacroiliac joints was performed in all cases. The diagnosis was bacteriologically confirmed in 24 cases (96%). The average duration of antibiotic treatment was 83 days in the pyogenic sacroiliitis, and 102 days in brucellar sacroiliitis. The evolution was favorable in 12 patients (48%), 9 patients (36%) had sequelae of sacroiliac joint pain and 4 patients (16%) died. In our study, time frame of infectious sacroiliitis evolution did not predict the causative bacterium, hence the need for bacteriological documentation in order to prescribe appropriate antibiotic therapy.
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Affiliation(s)
- Foued Bellazreg
- Service de Maladies Infectieuses, CHU Farhat Hached, Sousse, Tunisie
| | - Zeineb Alaya
- Service de Rhumatologie, CHU Farhat Hached, Sousse, Tunisie
| | - Zouhour Hattab
- Service de Maladies Infectieuses, CHU Farhat Hached, Sousse, Tunisie
| | - Nadia Ben Lasfar
- Service de Maladies Infectieuses, CHU Farhat Hached, Sousse, Tunisie
| | | | - Elyes Bouajina
- Service de Rhumatologie, CHU Farhat Hached, Sousse, Tunisie
| | - Amel Letaief
- Service de Maladies Infectieuses, CHU Farhat Hached, Sousse, Tunisie
| | - Wissem Hachfi
- Service de Maladies Infectieuses, CHU Farhat Hached, Sousse, Tunisie
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