[Prolonged fever in adults with normal sedimentation rate].
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Biomedical subjects
Publications and source records attributed to M Ernez.
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OBJECTIVES: Despite well-known neurological complications, post-exposure semple-type rabies vaccine is still used in Tunisia. We retrospectively studied neurological manifestations following post-exposure rabies vaccine. METHODS: Over a 3-year period, semple-type phenol inactivated lamb nerve tissue vaccine (Pasteur Institute, Tunis) was given to 1392 adults after exposure to rabies. RESULTS: The frequency of neurological complications was 1/200. Seven patients presented complications 4 to 14 days after the first vaccine injection (median 11 days). Central nervous system manifestations occurred in all 7 patients with peripheral neuropathy in 5. Manifestations were meningoradiculitis (n = 3), meningomyeloradiculitis (n = 2), meningomyelitis (n = 1) and myelitis (n = 1). No vaccine-associated death occurred, but one patient suffered persistant paraplegia. CONCLUSION: Semple-type adult animal nerve tissue vaccine produces an unacceptable rate of severe post-vaccinal neurological complications in adults. Human diploid cell rabies vaccine should be used for post-exposure rabies vaccination.
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11 cases (7 primary and 4 secondary) of pyogenic psoas abscesses are reported. In all cases Staphylococcus aureus was isolated on blood culture or pus drained under ultra-sonographic control. US is very useful for diagnosis and the follow up of psoas pyogenic abscesses. Percutaneous aspiration and drainage of psoas abscesses under ultrasonographic control combined to antibiotherapy is an effective therapeutic procedure. Our experience suggests that antibiotherapy alone is an effective therapy of presuppurative pyogenic psoas abscesses and even in collected and non complicated primary psoas abscesses.
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