Abstract: Introduction. Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. As of 2018, the World Health Organization (WHO) reports that approximately 10 million people worldwide have it. Tuberculosis is one of the top 10 causes of death. Spinal tuberculosis represents 50 to 60% of osteoarticular tuberculosis. Three main radioclinic forms have been described: tuberculous spondylodiscitis or Pott's disease, tuberculous spondylitis and primary tuberculosis of the posterior arch. The early diagnosis of spinal tuberculosis has become easy thanks to the progress of imaging and the development of disco-vertebral biopsy techniques. Chronic hemodialysis patients are particularly at risk of tuberculosis. Spondylodiscitis is more frequent in this population and threatens the vital prognosis. Observation: We report two cases of tuberculous spondylodiscitis diagnosed in the context of pelvic and lumbar pain. The biological work-up noted an inflammatory hypochromic microcytic anemia. The infectious workup was negative. MRI and CT scans showed lumbar spondylodiscitis in both cases. No disco-vertebral biopsy was performed. The diagnosis of tuberculous spondylodiscitis was made on the basis of clinical and imaging findings. A quadrithérapie anti bacillaire was instituted. The short-term evolution was favorable with disappearance of the pain, but one patient died of an unclear cause because the death occurred at home. Conclusion: Spinal tuberculosis is far from being rare in hemodialysis patients in Mali. It should always be considered in the presence of unlabelled pain, which will lead to the request of imaging examinations in order to evoke the diagnosis and to initiate antituberculosis treatment.Abstract: Introduction. Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis. As of 2018, the World Health Organization (WHO) reports that approximately 10 million people worldwide have it. Tuberculosis is one of the top 10 causes of death. Spinal tuberculosis represents 50 to 60% of osteoarticular tuberculosis. Three main radioclinic f...Show More
Boutaina Bouibaouen,Hicham El Bacha,Nadia Benzzoubeir,Tarik Gharbi,Ikram Errabih
Issue:
Volume 1, Issue 1, March 2022
Pages:
6-8
Received:
20 April 2022
Accepted:
6 May 2022
Published:
12 May 2022
DOI:
10.11648/j.ijmcr.20220101.12
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Abstract: The Glasgow-Blatchford Score is based on simple clinical and biological variables that identifies patients who are at low or high risk for therapeutic procedures (interventional endoscopy, surgery and/or transfusions). The aim of this work is to evaluate the prognostic contribution of the Glasgow-Blatchford score GBS during upper gastro-intestinal bleeding. Materials and methods: This is a prospective study from April 2020 to July 2021, involving patients who were hospitalized for upper GI bleeding. All patients underwent biological assessment, FOGD and therapeutic management. Follow-up was done during hospitalization and by telephone consultation after discharge. The analytical study was done using SPSS software. Results: The study included 73 patients with gastro-intestinal bleeding: hematemesis in 17 patients (23.28%), hematemesis and melena in 25 patients (34.24%), melena in 29 patients (39.72%) and rectorrhage in 8 patients (10.95%). The mean age was 56.5 years with a sex ratio (F/H)=1.28. The main diagnoses found were bleeding on portal hypertension in 13 patients (17%), gastro-duodenal ulcer in 23 patients (31.5%), gastric tumor in 4 patients (5%), angiodysplasias in 5 patients (6.8%), peptic esophagitis in (4%). endoscopy was normal in 12 patients (16%). The median GBS was 9 (6-10). The prevalence of hemorrhagic recurrence was 25.2%. Comparison of the two groups: Group 1 (who did not recur) and Group 2 (who recurred) showed a higher mean GBS in Group 2 which was 8 (4-10) compared to 5 (3-7) in Group 1 with (p=0.03). The median GBS was elevated to 9 (6-10) in the transfused group, compared to 6 (7-10) in the non-transfused group with a p=0.47. The median score in patients with normal fibroscopy is 7 (4.5-10) compared to patients with a bleeding endoscopic lesion which is 9 (6-10) with a p=0.19. Conclusion: The GBS is an easy prognostic score to assess in patients with upper GI bleeding. This score predicts the prognosis and the risk of recurrence of bleeding. Further studies are needed for a better discussion of this issue.Abstract: The Glasgow-Blatchford Score is based on simple clinical and biological variables that identifies patients who are at low or high risk for therapeutic procedures (interventional endoscopy, surgery and/or transfusions). The aim of this work is to evaluate the prognostic contribution of the Glasgow-Blatchford score GBS during upper gastro-intestinal ...Show More
