cas d’insuffisance rénale aiguë révélant une endocardite brucellienne et des complications neurologiques à Batna (Algérie)
Creators: name: BENAMMAR, Sonia
name: GUENIFI, Wahiba
name: MISSOUM, Soumia
name: KHERNANE, Chahinez
name: DJEDJIG, Fatiha
name: BOUKHALFA, Sana
name: ZOUZOU, Hanane
Publisher: name: MTSI
Year: 2022

description: Introduction. La brucellose est une anthropozoonose endémo-épidémique en Algérie, où elle constitue un problème de santé publique (incidence de 24,41 pour 100 000 habitants en 2017). La maladie est plus invalidante que fatale, les formes graves et les décès sont rares, sauf en cas de localisation cardiaque. Nous rapportons le cas d’un patient atteint d’une brucellose subaiguë multiviscérale compliquée. Observation. Un homme de 51 ans est hospitalisé en cardiologie pour endocardite, compliquée de manifestations neurovasculaires et cutanées, découverte au stade d’insuffisance rénale sévère, l’une des complications auto-immunes redoutables de l’endocardite infectieuse. Les diagnostics étaient confirmés par différents examens radiographiques et biologiques, l’étiologie brucellienne prouvée par l’examen bactériologique des hémocultures (Brucella melitensis) et le sérodiagnostic de Wright. Conclusion. L’évolution possiblement fatale de cette pathologie doit faire rappeler aux praticiens qu’il faut savoir l’évoquer dans un pays où la brucellose est endémique, agir rapidement et ne pas hésiter à demander au minimum un test sérologique. A case of acute renal failure revealing brucellian endocarditis and neurological complications in Batna (Algeria) Introduction. Brucellosis is a major zoonosis affecting livestock and transmitted to humans; it is widespread worldwide with 500,000 new cases per year according to the World Health Organization. It has become rare in countries that have established an eradication policy of the disease in animals and pasteurization of milk, but remains endemo-epidemic in Algeria, where it constitutes a public health problem (incidence of 24.41 per 100,000 inhabitants in 2017). The disease is more crippling than fatal. Severe forms are exceptional, and deaths are rare, most often following endocarditis or complicated neurological damage. The biological diagnosis is made by culturing the samples (mainly blood cultures), serology or molecular biology methods. We report the case of a patient with complicated and fatal subacute multiorgan brucellosis. Observation. A 51-year-old man is hospitalized in cardiology for endocarditis, complicated by neurovascular and skin manifestations, discovered in the stage of severe renal failure, one of the dreaded autoimmune complications of infectious endocarditis. The diagnoses were confirmed by various radiographic (echocardiography, brain computed tomography, magnetic resonance imaging) and biological examinations. The brucellian etiology was proved by bacteriological test of blood cultures (Brucella melitensis) and Wright’s serodiagnosis, in the absence of the Polymerase Chain Reaction (PCR) test. Conclusion. Brucellosis can have atypical, multiple, varied and misleading presentations, responsible for a difficult clinical diagnosis. The possibly fatal evolution of this pathology should remind practitioners to evoke it, in particular in front of a multivisceral infectious presentation, in a country where brucellosis is endemic. Clinicians must also act quickly and not hesitate to ask for at least a serological test.
description: MTSI, Vol. 2 No 1 (2022): MTSI-Revue