Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76133420131211Urinary Infection –One of The Most Common Bacterial Infections in Clinical Practice1181211825310.21608/aeji.2013.18253ENAngela RevelasPathological Department, St Nicolaos General Hospital –Crete ,GreeceKyriakos StefanidisSt. Paul General Hospital –Thessaloniki –Crete, GreeceJournal Article20131204<span>Urinary tract infection is one of the most common bacterial infections encountered in clinical practice. Most infections are uncomplicated. Complicated infections are caused by an abnormal urinary tract or a foreign body, the most common of which is catheter – associated urinary tract infection</span>Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76133420131210Pneumocystis jiroveci: Epidemiology and diagnosis1221261825410.21608/aeji.2013.18254ENZineb TlamçaniLaboratory of Peripheral Hospital Center, Taroudant, MoroccoMohammed Er-RamDepartment of Parasitology, Faculty of Medicine and Pharmacy of Fes, MoroccoJournal Article20131202<span>The Pneumocystis organism was initially described in 1909 by Chagas. Pneumocystis jiroveci is an uncommon opportunistic organism, which induces a severe and mostly fatal pneumonia in immunocompromised people. Pneumocystosis comes from reactivation of latent infection acquired while childhood or active acquisition while immunosuppression state. The epidemiology of Pneumocystis pneumonia (PCP) has changed considerably through the course of the HIV/AIDS epidemic. The establishments of PCP prophylaxis in 1989 and effective combination antiretroviral therapy in 1996, have resulted in substantial reduces in the incidence of PCP. Due to the insufficient specificity of clinical symptoms as well as the possibility of toxicity with therapy, the affirmation of PCP is important details for correct patient management. The traditional method for diagnosis of PCP depends on the microscopic visualization of organisms in respiratory samples. PCR diagnosis of P. jiroveci was introduced experimentally in 1990. Molecular methods, could detect P jirovecii DNA in respiratory samples from patients without clinically apparent PCP. In this review both epidemiology and diagnosis of Pneumocystis jiroveci will be discussed.</span>Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76133420131213Predictors of Death and Prolonged Hospital Length of Stay in Dengue Fever Patients Admitted to a Tertiary Hospital in Makkah.1271341825510.21608/aeji.2013.18255ENWael ShahinGastroenterology, Hepatology and Infectious Diseases Department,
Faculty of Medicine, Benha University, Benha, Egypt.Mohamed AlyInternal Medicine Department, Faculty of Medicine, South Valley
University, Qena, EgyptJournal Article20131202<strong>Background and study aim:</strong> Dengue fever is one of the commonest viral infections in tropical and subtropical areas and its main burden is related to patient's mortality and cost of hospital admission. Our aim was to study dengue fever patients admitted to a tertiary hospital as regards the predictors of patient's death and prolonged hospital length of stay (HLOS).
<strong>Patients and methods:</strong>This study included 123 patients. They were investigated for demographic, clinical and laboratory data that could predict the mortality and prolonged HLOS cases.
<strong>Results :</strong><em> </em>Ninety one patients were males (74%) and average age was 30.6 ± 13.8 years. 119 patients (96.7%) improved and 4 patients (3.3%) died in the hospital. Out of the 119 patients, 38 patients (30.9%) were discharged after 5 days. Statistically significant predictors of prolonged HLOS (> 5 days) were leucopenia, INR > 1.25 and Creatine Kinase (CK) serum level > 488 IU/dl. Predictors of patient's death were male, non Saudi patients, age > 41.5 years, and complicated case (ICU admission , CNS hemorrhage and renal and/or liver failure). On multivariate logistic regression analysis; the laboratory independent predictors of death were AST > 610 IU/dl, ALT > 150 IU/dl, PT > 16.65 sec and INR > 1.4.
<strong>Conclusion :<em> </em></strong>In a tertiary hospital in Makkah, the mortality rate of dengue fever patients was 3.3%.Predictors of patient's death were old age, male, non-Saudi patients, ICU admission, CNS hemorrhage, renal and liver failure and on multivariate logistic regression analysis, laboratory predictors were high serum levels of AST, ALT, PT and INR. About 31% of dengue fever patients needed hospital admission for >5 days and the statistically significant predictors were leucopenia, high INR and high CK serum levels.Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76133420131212Needle-Knife Fistulotomy as a Rescue Access of the Common Bile Duct in Cirrhotic Patients: Feasibility and Outcome1351451825610.21608/aeji.2013.18256ENYasser AEl-NaggarInternal Medicine Department, Faculty of Medicine, Zagazig University, EgyptMohamed IRadwanTropical Medicine Department, Faculty of Medicine, Zagazig University, EgyptMohamed HEmaraTropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt0000-0002-1504-7851Journal Article20131204<strong>Background and study aim:</strong> Cannulation of the common bile duct may require invasive procedures; such procedures may carry an increased risk of complications. This study aimed at comparing the safety and efficacy of the needle-knife fistulotomy with other techniques in cirrhotic patients after failure of the standard cannulation using the free hand needle knife.<br /> <strong>Patients and methods:</strong>Seventy cirrhotic patients were included and were divided into: Group A; 15 patients who underwent a needle-knife fistulotomy using the needle–knife after failure of transpapillary wire – guided cannulation. Group B : 15 patients who underwent a precut using the standard pull sphincterotome after failure of transpapillary wire – guided cannulation. Group C : 20 patients who underwent a conventional transpapillary wire – guided cannulation without sphincterotomy. Group D : 20 patients who underwent a conventional transpapillary wire – guided cannulation with standard sphincterotomy. Cannulation was evaluated for duration, number of trials, use of aiding instruments and success rate.<br /> <strong>Results :</strong><em> </em>Success rate of CBD cannulation and fair dye drainage was reported in 93.3% and 73.3%, 86.7% and 80%, 85% and 70%, 85% and 80% of patients in groups A,B, C and D respectively, with no statistically significant difference among the four groups. The only complication reported in group A was bleeding (three patients). No statistically significant difference among the four groups regarding post-procedural complications was noticed.<br /> <strong>Conclusion :<em> </em></strong>Suprapapillary needle – knife fistulotomy can be used in cirrhotic patients when standard biliary cannulation proves to be difficult, it is associated with a high success rate and a low complication riskZagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76133420131214Case 2-2013: Eosinophilic Ascites (EA); Pathophysiology, Differential Diagnosis and Therapeutic Challenges1461521825710.21608/aeji.2013.18257ENWalid A.Abd EldayemTropical Medicine Department, Faculty of Medicine, Zagazig University, EgyptAhmad SSherbiniTropical Medicine Department, Faculty of Medicine, Zagazig University, EgyptJournal Article20131202<span>The Eosinophilic ascites (EA) is a rare disorder of unknown etiology that has been reported in both adult and pediatric patients. It is a part of the eosinophilic gastroenteritis (EGE) syndrome, which is characterized by the presence of non specific abdominal complaints in association with eosinophil-driven inflammation of any or all layers of the gut wall. Peripheral eosinophilia may or may not be present. Here, we report a case of EA, a rare presentation of the serosal variant of EGE that developed in a thirty years old Egyptian female. She complained initially from nonspecific GI symptoms associated with diffuse abdominal pain and distention for several weeks. Her physical examination was significant for moderate ascites. Initial work-up demonstrated: very high peripheral eosinophilia, normal liver function tests, thickening of the small and large bowel walls, and normal total serum IgE. Upper endoscopy and extensive testing for malignancy and parasitic infections failed to establish a diagnosis. Ascetic fluid analysis showed significant eosinophilia. Further, a duodenal biopsy showed marked eosinophilic infiltration of the lamina Propria. This report adds to the scarce data on serosal involvement, "the rarest form of presentation" and illustrates that EGE complicated by ascites can be effectively treated with a combination therapy of steroids and the leukotriene receptor antagonist "Montelukast" after other systemic disorders associated with peripheral eosinophilia have been ruled out. The pathophysiology, differential diagnosis as well as therapeutic challenges associated with EGE are discussed</span>Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76133420131214Video Case: Autologous Blood Injection for Actively Oozing Gastric Ulcer1531531825810.21608/aeji.2013.18258ENMohamed EmaraTropical Medicine Department, Faculty of Medicine, Zagazig University, Egypt0000-0002-1504-7851Journal Article20131202<span>A 64-year old Egyptian male presented by first attack of hematemesis and melena. On endoscopic examination actively oozing gastric ulcer was seen. A total of 8 cc autologous blood (withdrawn from the cupital vein of the patient) was injected along the edges of the ulcer and bleeding stopped (defined as stoppage of bleeding at the time of endoscopy and stoppage of hematemesis and melena 24 h after autologous blood injection)</span>Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76133420131212Video Case: Sphincterotomy after Small Pre-cut of the Major Duodenal Papilla using Standard Sphincterotome1541541825910.21608/aeji.2013.18259ENTarik IZaherTropical Medicine Department, Faculty of Medicine, Zagazig University, EgyptJournal Article20131202<span>A 29-year old Egyptian female presented by pain in the right hypochondrium. Abdominal ultrasonography revealed mild dilatation of the common bile duct (CBD). On endoscopic retrograde cholangiopancreatography (ERCP) cannulation of the CBD was difficult.Small pre-cut for few millimeters upwards starting from the orifice of the major duodenal papilla using the standard shincterotome was performed .Then Cannulation of the CBD and sphincterotomy were successful. Small stone was extracted from the CBD by balloon</span>Zagazig University, Faculty of Medicine, Endemic and Tropical Medicine DepartmentAfro-Egyptian Journal of Infectious and Endemic Diseases2090-76133420131213Image Case: Diverticulosis of the Sigmoid Colon in a 63 Years Old Male1551551826010.21608/aeji.2013.18260ENTarik ZaherTropical Medicine Department, Faculty of Medicine, Zagazig University, EgyptJournal Article20131208<br /><span>In this case a 63 years old Egyptian male presented by lower left abdominal pain and was diagnosed by CT as having diverticulosis of the sigmoid colon. Colonoscopy confirmed the diagnosis and excluded malignancy </span>