[Bone and osteoarticular tuberculosis in black African immigrants. Apropos of 26 cases].
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Biomedical subjects
Publications and source records attributed to Y Mafart.
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A study of 357 cases of tuberculosis in African negro immigrants seen between 1967 and 1971 showed the predominance of respiratory lesions especially pulmonary and/or hilar ganglio-mediastinal lesions compared with lesions elsewhere, e.g. lymph nodes, bones, joints, pericardium, peritoneum, livers, and the frequency of multiple lesions. Routine detection should be more frequent in high risk subjects, who are almost always allergic on arrival in France. In spite of frequent resistance, above all primary, treatment gave good results in 83% of cases. In future, we will have to take into consideration the possibility of relapses and perhaps more numerous resistances, including to rifamycin and ethambutol.
33 ethylic patients with motor, personality and behavior disturbances have been treated successfully by tiapride. An oral dose of 5 mg/kg per day was observed to be sufficient in the treatment of lingual and hand tremors. However, in presence of behavior and/or personality disturbances and in predelirium the intramuscular route should be used at the dose of 10 mg/kg per day.
Twelve cases of pneumococcal septicemias are studied in a department of internal medicine. These septicemias involved pneumonias often large, multilobular and bilateral, with often pleural effusion purulent or not and in one occurrence meningitis. There was three deaths by acute respiratory failure in one case of liver cirrhosis and in another case of chronic lymphocytic leukemia. Conditions of antibiotherapy and possible intensive care are discussed, prognosis factors as splenic insufficiency (in sickle cell anemia and after splenectomy) and immune defense against pneuococcus are recalled.
Lymphographic data in 23 negro immigrants with lymph nodes tuberculosis almost always mediastinal and/or superficial are reported. In six cases, including two cases with abdominal latero-aortic lymph nodes clinically obvious, lymphography showed abnormalities without doubt. These aspects are compared with data of literature and discussed according to interpretation and significance in tuberculosis very peculiar in negro immigrants.20
Authors give results about 60 laparoscopies in negro immigrants. If one excepts isolated cases of liver cirrhosis, hepatoma, staphylococcic liver abscess, lymphosarcoma or schistosomiasis of the peritoneum and twelve normal laparoscopies, the most frequent diagnosis in this peculiar group is peritoneal and/or liver tuberculosis (21 cases). Endoscopic aspects of hepato-splenic schistosomiasis are summarized. Interest of liver and/or peritoneal biopsies is underlined. Problem of liver granulomatosis may be ambiguous between schistosomiasis and tuberculosis.
Case report of a sarcoidosis in a young west-indies feurale: ganglio-mediastinal and lung lesions, liver and salivary glands right optic nerve with retrobulbar optic neuritis. This lesions were quickly and totally reversible with tetracosactide and prednisone therapy.
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