Bécégite généralisée : étude de quatre observations

Inoculation by the BCG in the birth is compulsory in our country since 1959. Adverse reactions induced by vaccination with the BCG are rare varying from zero to 23.8%. Spread infections are even rarer and their estimated incidence is 0.1 to 4.3 per one million vaccinated children. The fatal disseminated BCG infection is exceptional and affects especially the children presenting an immune defect. The role of a familial gene defect needs to be taken into consideration. The BCG osteitis is found in second position in clinical forms after the suppurative lymphadenitis; it arises generally five months to five years after the vaccination. We report four observations of disseminated BCG infection occuring in children from three months to four years with a mortal evolution in two cases. Our objective is to discuss pathologic aspects of BCG disease.     

Méningite à Streptococcus salivarius avec bactériémie révélant un cholestéatome de l'apex petreux

Streptococcus salivarius meningitis are uncommon and often iatrogenic. We describe the case of a patient with community-acquired Streptococcus salivarius meningitis that revealed petrous apex cholesteatoma. A 50-years old patient was hospitalized because of severe headache, fever (39 °C), vomiting, and confusion. Cerebrospinal fluid (CSF) showed 2044 cells/mm³ with 91% neutrophils, Gram positive cocci, protein level > 2.5 g/L, glucose level 2.5 mmol/L (glycemia 7.1 mmol/L). Two blood cultures and CSF culture were positive with Streptococcus salivarius. Evolution was good with amoxicillin treatment. The patient had rhinorrhea and chronic otitis. Cholesteatoma was revealed in a scanner, and was opered. Community-acquired Streptococcus salivarius meningitis are unfrequent, and can reveal ENT pathology like cholesteatoma.     

Diarrhées post-antibiothérapie

Antibiotic associated diarrhea is a common adverse reaction to most types of antibiotics. Beside risk factors with the type and duration of antibiotic therapy, host factors include the extremes of ages (< 6 years or > 65 years), severe underlying disease, prior history of antibiotic associated diarrhea and exposures during recent hospitalization. The key to decreasing these consequences is prompt diagnostic followed by effective treatment and institution of control measures and preventive traetments in patients at risk.