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Long-Term Fever and Cytomegalovirus Infection in the Field of HIV Immunosuppression in Two Cases and Review of the Literature

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Open Journal of Internal Medicine 2020年第2期10卷 151-159页

作者： Angèle Azon-Kouanou Kouessi Anthelme Agbodande Marius Doukpo mahoutin semassa ghislain missiho Roberto Dossou Torès Kouassi Prudencio Crescent Darius Cossou-Gbéto Eugénie Dansou Djimon Marcel Zannou Fabien Houngbe Internal Medicine and Medical Oncology Department National Teaching Hospital (NTH) Hubert Koudougou Maga (HKM) Cotonou Benin

Cytomegalovirus (CMV) infection is an infection that most often affects immunocompromised individuals with a seroprevalence of more than 80%. CMV co-infection is associated with increased mortality in HIV-infected individuals despite antiretroviral treatment. It has the potential for hematogenous dissemination to all the organs, but only becomes symptomatic when the viral load is high. This is especially possible when the human immune system is well controlled so that the individual infected with CMV generally remains asymptomatic, and possibly for a long period. Once the immune system fails, CMV infection becomes symptomatic. Diagnosis is not easy and is often done postmortem in developing countries with limited technical facilities. We report here two cases diagnosed at the Internal Medicine Service of the CNHU-HKM in Cotonou. The patients were infected with HIV and had a long term fever. The diagnoses were made on the basis of CMV serology. The first diagnosis was post-mortem, and the second patient died 48 hours after the start of the treatment.

关键词： CMV Infection HIV Deaths Cotonou

Bacteriologically Confirmed Neuromeningeal Tuberculosis at the Hubert Koutoukou Maga National Hospital and University Center in Cotonou: About Two Cases Study and a Review of the Literature

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Open Journal of Internal Medicine 2020年第2期10卷 190-197页

作者： Angèle Azon-Kouanou Kouessi Anthelme Agbodande Leoubou Roger Samuel Dodo mahoutin semassa ghislain missiho Roberto Dossou Torès Kouassi Prudencio Delphin Murhula Marius Doukpo Eugénie Dansou Thomas Lokossou Djimon Marcel Zannou Fabien Fabien Internal Medicine Department of CNHU-HKM Cotonou Benin Multi-Purpose Anesthesia and Resuscitation Department of CNHU-HKM Cotonou Benin

Introduction: Tuberculosis remains a major public health problem. The damage to the central nervous system is severe. We reported here two cases. Clinical Case 1: A 37-year-old female patient, naively Human Immunodeficiency Virus1 (HIV1)-positive with antiretroviral (ARV) treatment, hospitalized in the Internal Medicine department for altered consciousness in a febrile context. The clinical examination at admission noted a meningeal syndrome. Cytological analysis of the cerebrospinal fluid (CSF) revealed lymphocytic meningitis with 98% lymphocytes for 3634 leukocytes. CSF polymerase chain reaction (PCR) detected Mycobacterium tuberculosis DNA. She was put on anti-tuberculosis treatment. The immediate course was favourable, but a secondary worsening of the clinical picture was the cause of his death. Clinical Case 2: A 34-year-old male patient, naively HIV1-positive with ARV treatment. He is hospitalized in the Multi-Purpose Anaesthesia and Resuscitation Department of the CNHU HKM for altered consciousness in a feverish context. The clinical examination noted a meningeal syndrome. The cytological analysis of the CSF noted 184 leukocytes for 99% lymphocytes. The CSF PCR identified the DNA of Mycobacterium tuberculosis. He was put on anti-tuberculosis treatment. The evolution was marked by his death. Conclusion: The neuromeningeal localization of tuberculosis is a poor prognosis. Co-infection with HIV remains a potential deadly combination.

关键词： Neuromeningeal Tuberculosis HIV Infection Death Cotonou

Reasons for the Use of Health Care in Elderly Persons Undergoing Consultation in the University Clinic of Internal Medicine and Medical Oncology of the Hubert Koutoukou Maga National Hospital and University Center (CNHU-HKM) of Cotonou

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Open Journal of Internal Medicine 2020年第3期10卷 280-287页

作者： Angèle Azon-Kouanou Mahougnon Jean-Christ Alix Aïdasso mahoutin semassa ghislain missiho Eugénie Dansou Faustin Havugimana Karuhije Janvier Kitumaini Kondoli Richard Oba Kouessi Anthelme Agbodande Yves Morel Sokadjo Djimon Marcel Zannou Fabien Houngbé Internal Medicine Department of Hubert Koutoukou Maga National Hospital and University Center in Cotonou (CNHU-HKM) Cotonou Benin

Introduction: The progressive ageing of the population from southern Sahara is leading to an increase in health needs among the elderly. The purpose of this study was to output an overview about the reasons why the elderly come for consultation in the internal medicine department of the HKM-NHUC in Cotonou. Methodology: This was a retrospective, descriptive, and analytical study, which included all patients aged 65 years and over, who came for the first time for consultation in the Internal Medicine Department of the CNHU-HKM between January 1st and December 31st, 2017. Results: Among the 680 new patients received in internal Medicine consultations during the study period, 118 people were aged 65 and over, representing a hospital frequency of 17.35%. The sex ratio was 0.9 with a mean age of 73 ± 7 years. Hypertension was the main comorbidity of the patients (69%). Cough (11.3%) and low back pain (8.2%) dominated the reasons for consultation. The three main nosological groups of pathologies were, in descending order, diseases of the osteo-articular system (17.5%), diseases of the respiratory system (16.5%) and diseases of the circulatory system (12.4%). Pneumonia (11.3%) and lumbosacral spondylarthrosis (10.3%) were the most frequent pathologies in patients whose health needs remain quite varied. Conclusion: The elderly become gradually an important part of the population in southern Sahara. A better understanding of the health needs of this category of the population is necessary to deal effectively with the health challenges that will accompany this phenomenon.

关键词： The Elderly Reason for Consultation Internal Medicine

Therapeutic Itinerary of Patients Followed for Connectivitis in the Internal Medicine Department of the CNHU-HKM of Cotonou (Benin)

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Open Journal of Internal Medicine 2021年第2期11卷 73-80页

作者： Angèle Azon-Kouanou Kouessi Anthelme Agbodande Eugénie Dansou mahoutin semassa ghislain missiho Yves Morel Sokadjo Armand Finagnon Wanvoegbe Janvier Kitumaini Kondoli Richard Oba Roberto Dossou Tores Kouassi Prudencio Djimon Marcel Zannou Fabien Houngbé Internal Medicine and Medical Oncology Department National Teaching Hospital (NTH) Hubert Koudougou Maga (HKM) Cotonou Bénin

Introduction: In black Africa, connectivites have been for a long time a source of diagnostic erraticity because of their clinical polymorphism. This study aims to determine the therapeutic itinerary of patients followed for connectivitis in the Internal Medicine Department of the CNHU HKM of Cotonou. Methodology: This is a cross-sectional study that included patients followed for connectivitis in the HKM-Cotonou Internal Medicine Department from January 2010 to October 2018. Results: Out of 3600 patients hospitalized in the study period, 21 had connectivitis, i.e. a hospital frequency of 0.58%. Of the 21 patients collected, 18 met the inclusion criteria. The mean age was 40 (±11) years old and the youngest was of 21 and the oldest 58. The sex ratio was 17.9. The “Fon” ethnic group was the most represented (33.3%) and 15 (83.3%) subjects were Christians. Systemic lupus erythematosus was the most frequent connectivitis (55.6%). The average time of consultation was 38 months. Witchcraft was the most incriminating cause (78%). Ten (55.5%) patients had resorted to self-medication as their first choice of treatment, 5 (27.8%) to traditional medicine treatment and 3 (16.7%) to prayer for healing. The reasons for the first choice of treatment were satisfaction (44.4%), financial problems (27.8%), trivialization of the disease (16.7%), and advice from family and friends (11.1%). The consultation at the CNHU followed a referral from a first contact health structure (61%) or an initiative of the patient (27.8%). Conclusion: Connectivitis is a source of diagnostic error in our context. Awareness must be raised among patients for an early consultation at the first symptoms.

关键词： Connectivitis Therapeutic Itinerary CNHU-HKM Cotonou

Knowledge of General Practitioners in Cotonou about Systemic Lupus Erythematosus

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Therapeutic Itinerary of Patients Followed for Connectivitis in the Internal Medicine Department of the CNHU-HKM of Cotonou (Benin)

Open Journal of Internal Medicine（内科学期刊） 2020年第4期

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Factors Associated with High Blood Pressure in People Living with HIV at the National Teaching Hospital Hubert Koutoukou Maga and Cotonou Teaching Hospital of the Armed Forces

Open Journal of Internal Medicine（内科学期刊） 2021年第2期

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Open Journal of Internal Medicine 2021年第4期11卷 283-297页

作者： Azon Kouanou Angèle Ayihounton Gaël Derrick Mémoire Dégbo Agbodande Kouessi Anthelme Sokadjo Yves Morel missiho mahoutin semassa ghislain Faladé Adélakoun Ange Géoffroy Zannou Djimon Marcel Houngbé Fabien Internal Medicine-Medical Oncology Unity of the National Teaching Hospital Center (NTHC)-Hubert Kougougou Maga (HKM) of Cotonou Cotonou Benin National Reference Center for Research and Care (CNRRPEC) of HIV Infection Cotonou Benin

In Benin Republic, few data are available on the prevalence and determinants of arterial hypertension (AH) in people living with the human immunodeficiency virus (PLWHA). The present study was conducted in two outpatient treatment centers for PLWHA in Cotonou and was conducted from June 19 to July 04, 2019 with 314 PLWHA. We performed descriptive statistics and logistic regression for the estimates. The prevalence of high blood pressure (HBP) among PLWHA was 41.4% [CI (95%): (35.9 - 47)]. In univariate analysis: age, smoking, alcoholism, physical inactivity, family history of hypertension, personal history of diabetes, obesity, and total and LDL (low density lipoprotein) hypercholesterolemia were significantly associated with HBP. No association was found with duration of HIV (human immunodeficiency virus) infection, time to ARV (antiretrovirals) exposure, and treatment regimen. In multivariate analysis, age, sex, smoking, family history of hypertension, and total hypercholesterolemia remained associated with HBP. In conclusion, the prevalence of HBP in PLWHA was very high compared with the results in the general population, and the same risk factors described in the general population were found but with a more marked hypertense potential.

关键词： High Blood Pressure HIV Associated Factors Cotonou (Benin)

Cancer and Covid-19 in the Department of Internal Medicine and Medical Oncology at the National Teaching Hospital Hubert Koutoukou Maga of Cotonou, about 4 Cases: A Review of the Literature

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Open Journal of Internal Medicine 2021年第4期11卷 298-309页

作者： Azon Kouanou Angèle Agbodandé Kouessi Anthelme Sokadjo Yves Morel missiho mahoutin semassa ghislain Faladé Adélakoun Ange Géoffroy Murhula Katabana Delphin Kouanou Olamidé Marlene Marie Dénise Ahoussoussi Cornelly Tokpanoudé Elodie Zannou Djimon Marcel Internal Medicine-Medical Oncology Unity of the National Teaching Hospital Center (NTHC)-Hubert Kougougou Maga (HKM) of Cotonou Cotonou Benin Internal Medicine Department University Clinics Bukavu (U.O.B) Democratic Republic of the Congo

Coronavirus Disease-19 (COVID-19) manifests itself by a respiratory attack that can go from mild to severe forms. The factors favoring the severe forms are age, arterial hypertension, diabetes mellitus, and cancer. We report 4 cases of COVID-19 on cancer, followed in the Department of Internal Medicine and Medical Oncology of National Teaching Hospital Center Hubert Kougougou Maga (NTHC-HKM). Case 1: A hypertensive 65-year-old female patient with a severe form of COVID-19 on an FIGO (International Federation of Gynecology and Obstetrics) IVB endometrioid adenocarcinoma with pulmonary metastasis: unfavorable evolution under treatment with death. Case 2: A 56-year-old hypertensive patient with severe COVID-19 with pulmonary metastatic recurrence of SBRIII, HER2 positive invasive ductal carcinoma of the left breast: favorable evolution with cure of COVID-19, subsequent death related to active tumor. Case 3: A 37-year-old patient with a moderate form of COVID-19 with hepatocellular carcinoma complicating post alcoholic cirrhosis, CHILD C: favorable evolution with cure of COVID-19, patient lost to follow-up. Case 4: A 56-year-old patient, hypertensive, type II diabetic, presenting a severe form of COVID-19 on a field of ovarian serous adenocarcinoma of high grade FIGO IV A with pleuropulmonary metastasis: favorable evolution with cure of COVID-19, subsequent stroke, patient followed in palliative home hospitalization. The diagnosis of COVID-19 in cancer with pulmonary metastases is difficult. The pulmonary location of tumors seems to be a factor favoring severe forms.

关键词： COVID-19 Cancer NTHC-HKM

Factors Associated with High Blood Pressure in People Living with HIV at the National Teaching Hospital Hubert Koutoukou Maga and Cotonou Teaching Hospital of the Armed Forces

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