African histoplasmosis due to Histoplasma duboisii (Histoplasma capsulatum var. duboisii): fourteen cases observed in Congo during 10 years (1981-1990)

peer reviewedFourteen cases of histoplasmosis due to Histoplasma duboisii seen in Congo from 1981 through 1990, are reported: the average age of the patients was 25 years (the youngest being 1,5 y and the oldest 50y), the M/F ratio was 2,5; most of the patients (10/14) live in a rural area. there was a rather constant frequency of one to three cases per annum from 1981 through 1990. The fisrt congolese AIDS-associated systemic histoplasmosis duboisii case was observed in 1990. Lymph node involvment and mucocutaneous lesions were the most frequent clinical manifestations. In all cases, the disgnosis was established by histological examination. When performed, direct microscopy was always positive (11/11). Isolation of H. duboisii in culture was successful in 7 out of 9 attempts. Two cases of systemic infection were rapidly fatal but a good clinical response was obtained in the other cases wih amphotericin B, which due to intolerance, was replaced by ketoconazole in 2 patients.De 1981 à 1990 nous avons collecté au Congo 14 observations d'histoplasmose à Histoplasma duboisii. Globalement on relève: un sex ratio de 2,5; un âge moyen de 25 ans, avec des extrêmes de 1 an et demi et 50 ans; une majorité de patients (10 sur 14) vivant en milieu rural; une fréquence relativement stable avec de 1 à 3 cas de 1981 à 1990, date à laquelle la première forme diffuse a été observée au cours d'un SIDA. Les atteintes ganglionnaires et cutanéo-muqueuses sont les plus fréquentes. Le diagnsotic a toujours comporté la mise en évidence des levures par l'examen histologique. L'examen direct d'un produit pathologique a été positif dans tous les cas où il a été réalisé (11/11), mais la culture est restée négative à deux reprises. les deux formes disséminées ont été rapidement mortelles. Pour les autres observations l'évolution, à court terme et moyen terme, a toujours été bonne sous amphotéricine B. Dans deux cas, des intolérances ont conduit à prescrire du kétoconazole

Histomolecular profile of Helicobacter pylori strains circulating in Brazzaville (Congo)

Abstract Background and Aim Helicobacter pylori (Hp) infection is a real public health problem in the Congo. We aimed study the histomolecular profile of Hp strains circulating in Brazzaville, Congo, in order to contribute to the improvement of Hp‐infected patients in the country. Methods This was an analytical‐transversal study carried out from January to November 2020 (i.e. a study period of 11 months) in the endoscopy centers of Brazzaville as well as the molecular biology and anatomopathology laboratories of Pointe‐Noire and Oyo. It involved 100 symptomatic patients over the age of 18 referred for upper GI endoscopy. These patients underwent gastric biopsies for histopathological analysis according to the Sydney classification and molecular analysis using the real‐time polymerase chain reaction (PCR) technique. The frequency of Hp infection was determined using real‐time PCR. PCR was also used to identify the Hp strains and assess their tropism in the gastric mucosa. Digestive symptoms, endoscopic lesions, and histopathological lesions associated with HP infection were studied. Results The incidence of Hp infection was 91%, with a female predominance of 52.75% and an average age of 46.32 years. Endoscopy revealed normal mucosa (56.14%), ulcerated lesions (12.28%), and gastritis (22.81%) in infected patients. Histopathologically, the lesions were chronic atrophic gastritis (91%), with inflammatory activity (16.46%), intestinal metaplasia (16.46%), and adenocarcinoma (3.3%). Cag A strains were present in 85.71% of cases and had no preferential tropism in the gastric mucosa. Strains carrying the Cag A gene were present in severe and serious endoscopic and histopathological lesions. Conclusion The prevalence of Hp infection is 91% in the Brazzaville population. Cag A strains circulate in high proportions and are implicated in the occurrence of severe lesions of the gastric mucosa