Pulmonary and Extra-Pulmonary Tuberculosis: Epidemiological and Diagnostic Aspects at Sominé DOLO Hospital in Mopti

Despite the efforts made to fight the tuberculosis, Mycobacterium tuberculosis still remains a public health problem, particularly for low-income countries. According to the World Health Organization data, our country, Mali has detected only half of the 10,385 cases of tuberculosis expected for 2014 for a population of 17,309,000 inhabitants. The objective of this present work was to describe the different clinical aspects and the epidemiology of tuberculosis at Hospital Sominé Dolo in Mopti. We performed a retro-prospective and descriptive of tuberculosis cases diagnosed in our department of medicine between May 2016 and August 2018. A total of 96 tuberculosis cases were recorded, i.e. 4.6% and 1.0% for hospitalizations and consultations patterns, respectively. The median of age was 41 with extremes from 5 to 80 years. The age group [31 - 40 years] was the most affected with 20.8%. Men and women were affected in identical proportions, i.e. 50%. Pulmonary locations were the most frequent with 55.2%. Pleural tuberculosis was far the most frequent of the extra-pulmonary forms with 24.0% followed by the peritoneal and bone localization with 6.3% each. The majority of patients were followed on an outpatient basis, i.e. 90.6%. The disease lethality was 7.3%. Our data show that the cases of extra-pulmonary tuberculosis are in an increasing proportion and their diagnosis confirmation remains difficult in our context.

Bart’s Syndrome: A Neonatal Observation about a Case Report

Introduction: Bart’s syndrome is a rare neonatal pathology combining congenital skin aplasia affecting the extremities and congenital epidermolysis bullosa, exceptionally described on black skin. Observation: A 2-day-old male newborn was referred for multiple ulcerations of the limbs observed at birth. The clinical examination found an absence of bilateral and symmetrical skin occupying almost all of the two lower limbs with some flaccid bubbles. The vascular network was clearly visible. The rest of the skin coating was normal. The diagnosis of Bart syndrome in connection with epidermolysis bullosa was evoked clinically and despite pediatric and dermatological management, the evolution was rapidly fatal by severe sepsis. Discussion: Bart syndrome corresponds to a clinical picture of congenital skin aplasia associated with congenital epidermolysis bullosa suspected by areas of fragility and sometimes bubbles. All types of congenital epidermolysis bullosa may be associated with this syndrome. The clinical diagnosis is generally easy but the therapeutic management is difficult and the prognosis reserved. Conclusion: Bart syndrome is a curious congenital association of well-defined skin symptoms, the etiopathogeny of which still remains poorly elucidated, hence the difficulty of establishing an antenatal diagnostic strategy or giving appropriate genetic advice.