|
|
| |
| Pneumocystose : A propos de 15 cas de pneumocystose diagnostiqués au centre hospitalier Hassan II de Fès
Download PDF
|
J. Elamouri,, S. Adadi,,K. Lemhouer,, H. Bensaghroune, Z. Tlamçani,
|
Abstract:
: IntroductionPneumocystis is a pulmonary mycosis caused by an opportunistic cosmopolitan fungus called Pneumocystis jirovecii. It occurs mainly in immunocompromised HIV and non-HIV patients, but also in rare cases of immunocompetent patients. The objective of this work is to determine the epidemiological, clinical and biological characteristics of pneumocystis diagnosed in the laboratory of parasitology-mycology of the CHU HASSAN II of Fez. Materials and methods:Our work is a prospective study of a series of 15 cases of pneumocystis diagnosed over a period of 3 years from January 2019 to January 2022, in the department of parasitology - mycology of the Hassan II Hospital of Fez. We included the patient's identity, sex, age, and clinical and biological data. The methods used for the biological diagnosis were the detection of trophozoites and cysts of P. jirovecii by microscopic examination of the specimens, after staining with toluidine blue and May-Grünwald Giemsa (MGG), and direct immunofluorescence. Results:Of the 62 mycological specimens taken during the study period, 15 were positive for pulmonary pneumocystis. The average age was 59 years with a male predominance. Among these patients only one was immunocompetent and the others were immunosuppressed, one of whom was HIV positive,2 (14.2%) were treated for solid cancer and 9 (64.2%) had various immunosuppressions (5hematological malignancies, 2 PRRI, one pulmonary tuberculosis and one vasculitis),50% had received immunosuppressive therapy and 57.1% long-term corticosteroid therapy prior to the diagnosis of pneumocystis with 4(28.5%) having COVID 19 related pneumopathy. The presenting signs were classic, dominated by fever, cough and dyspnea in all patients. All specimens examined were respiratory specimens, of which 5 were BAL examinations. The evolution was favorable in 78.57% of cases and we deplored 7.14% of deaths. More than 57% of patients were receiving corticosteroid therapy. Conclusion:Pneumocystis, which mainly affects the immunodeficient, is experiencing an increase in the number of cases, initially associated with the AIDS pandemic, but in recent years is related to increasingly diverse immunodeficiency pictures. This mycosis can have a fatal outcome and must be evoked in front of any respiratory symptomatology on a debilitated ground.
|
|
|
| | |