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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

Kaposi’s sarcoma Associated with Gastrointestinal Bleeding: A Rare Complication of Long-Term Corticosteroid Therapy

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Open Journal of Internal Medicine 2015年第4期5卷 75-80页

作者： Angèle Azon-Kouanou Djimon Marcel Zannou Kouessi Anthelme Agbodande Cossi Angelo Attinsounon Albert Dovonou roberto dossou torès kouassi prudencio Dédé Priscillia Tatiana Baglo Fabien Houngbe National Teaching Hospital-HKM of Cotonou University of Abomey-Calavi Abomey-Calavi Benin Departmental Hospital of Borgou-Alibori University of Parakou Parakou Benin

Corticosteroid therapy has revolutionized the treatment of many diseases in medicine. The most concerned diseases are chronic inflammatory diseases. Its use may be either short-term or long-term, thus generating several side effects, some of which are conventional and known, but others are rare, such as Kaposi’s sarcoma. We report here a particular clinical observation. Observation: This is a patient of 37 years, who consults in Internal Medicine for the treatment of mucocutaneous lesions, papular nodular, hyper pigmented, budding and disseminated appeared after six months of corticosteroid therapy. This treatment was introduced for the treatment of acoustic neurinoma. The patient is not diabetic or alcoholic and has a negative HIV status. The diagnosis of Kaposi’s sarcoma was made by histology of biopsied skin lesions which concluded for a regular proliferation without atypia spindle cell or mitosis. The lesions persisted over a month despite discontinuation of corticosteroid therapy. Treatment with Bleomycin was necessary. The outcome was favorable under treatment with progressive and complete disappearance of lesions after 15 treatments. Conclusion: The classical side effects of long-term corticosteroid are known, but Kaposi sarcoma complicating long-term corticosteroid is rare in the literature. It is vital that any long-term corticosteroid should be the subject of careful and regular monitoring.

关键词： Kaposi sarcoma Long-Term Corticosteroid Rare Adverse Effects

Primary Duodenal Adenocarcinoma Revealed by Chronic Iron Deficiency Anemia:Diagnostic Difficulties in a Case Report in Internal Medicine CNHU HKM-COTONOU

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Open Journal of Internal Medicine 2015年第4期5卷 92-95页

作者： Angèle Azon-Kouanou Djimon Marcel Zannou Aboudou Raimi Kpossou Kouessi Anthelme Agbodande roberto dossou torès kouassi prudencio Jean sehonou Gaspard Gbessi Freddy Gnangnon Gabriel Ade Fabien Houngbe Internal Medicine and Medical Oncology Department National Teaching Hospital(NTH)Hubert Koudougou Maga(HKM)CotonouBenin Hepato-Gastroenterology Department National Teaching Hospital(NTH)Hubert Koudougou Maga(HKM)CotonouBenin Visceral surgery Department National Teaching Hospital(NTH)Hubert Koudougou Maga(HKM)CotonouBenin

The location of a primary duodenal adenocarcinoma is exceptional. Only few cases have been reported in the literature. We hereby report a case of primary adenocarcinoma of the duodenum with a 60 years old patient admitted because of chronic iron deficiency anemia. Endoscopic examination revealed a budding and ulcerated process in the second duodenum. The biopsy analysis showed primary adenocarcinoma. No other primary tumor was found. The staging directed showed cephalic pancreatic invasion. The patient died in the aftermath of a surgical management.

关键词： Chronic Iron Deficit Adenocarcinoma Duodenum Benin

Healthcare-Associated Bacteremia and Urinary Tract Infections in Wards A and B of Medicine Department, CNHU-HKM of Cotonou: Characteristics and Risk Factors

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Open Journal of Internal Medicine 2018年第1期8卷 42-53页

作者： Angèle Azon-Kouanou Kouessi Anthelme Agbodande Faridath Abèni Tatiane Massou Dissou Affolabi roberto dossou torès kouassi prudencio Carin Ahouada Komi Habada Murhula Katabana Delphin Djimon Marcel Zannou Fabien Houngbé Internal Medicine Department National Teaching Hospital Hubert Koutoukou Maga of Cotonou Bénin Bacteriology-Virology Department National Teaching Hospital Hubert Koutoukou Maga of Cotonou Bénin

Introduction: Healthcare-associated infections are involved in hospital long-stay and in the increase in inherent costs to patients care. Objectives: Objective was to describe the characteristics of healthcare-associated bacteremia and urinary tract infections in medical wards of CNHU-HKM of Cotonou, describe the distribution of germs identified according to admission wards and identify factors associated with onset of healthcare-associated infections. Materials and Methods: It was a cohort study conducted from 4th April to 16th september 2016. The study population included patients admitted in wards A and B of CNHU-HKM Medicine department for at least the past 48 hours, or readmitted in one of the medical wards less than 14 days after their discharge from hospital. Results: The study included 825 patients in total. Prevalence of healthcare-associated infections was 9.8%. Bacteremia was the most represented group (65.4%). The most often identified germs regardless of the site were respectively: K. pneumonia (38.5%), s. aureus (23.1%) and E. coli (20.0%). HIV+ status, internal medicine department, nephrology and endocrinology, duration of admission and the use of urinary catheter represent factors statistically associated with the onset of healthcare-associated infections. Conclusion: Healthcare-associated infections are a real public health issue in CNHU-HKM Medicine Department. There is pressing need to conduct a study on clinical hygiene so as to assess healthcare staff in practice.

关键词： Healthcare-Associated Infections Bacteremia Urinary Tract Infections Risk Factors

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

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 follo... 详细信息

strong>Introduction:strong> 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. strong>Methodology:strong> 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. strong>Results:strong> 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%). strong>Conclusion:strong> 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

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

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