Publications by authors named "Adnene Toumi"

16 Publications

  • Page 1 of 1

Cerebral nocardiosis with osteomyelitis of skull vault complicating a primary neck lesion in an immunocompetent patient: a case report.

Pan Afr Med J 2021 12;38:349. Epub 2021 Apr 12.

Infectious Diseases Department, Fattouma Bourguiba Hospital, Monastir, Tunisia.

Nocardia infection is an uncommon and rare condition in immunocompetent patient. A case of cutaneous nocardiosis complicated with osteomyelitis of the vault scalp in a 64-year-old man, with no remarkable past medical history, is reported. Treatment with trimethoprime-sulfamethoxazole than doxycycline for 12 months led to complete resolution and no evidence of recurrence was noted. Nocardia infection should be considered even in immunocomptent patients and doxycycline is a good alternative for treatment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11604/pamj.2021.38.349.26635DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8308935PMC
August 2021

Mycoplasma pneumoniae-induced rash and mucositis: A new entity.

Indian J Dermatol Venereol Leprol 2021 Mar 12:1-5. Epub 2021 Mar 12.

Department Dermatology Fattouma Bourguiba University Hospital, University of Medicine, University of Monastir, Monastir, Tunisia.

Mycoplasma pneumoniae is a well-known cause of community-acquired pneumonia, mostly associated with dermatological manifestations especially with mucosal involvement and targetoid cutaneous lesions. For many years, it was considered among the spectrum of erythema multiforme. Recently, some authors have recommended the creation of a new syndrome called "mycoplasma-induced rash and mucositis." This new syndrome has distinct epidemiological, clinical and histological features making it different from drug-induced Stevens-Johnson syndrome, toxic epidermal necrosis and erythema multiforme. Herein, we report two patients with acute Mycoplasma pneumoniae respiratory tract infection presenting severe mucocutaneous lesions in accordance with this new syndrome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.25259/IJDVL_660_19DOI Listing
March 2021

Necrotising otitis externa: A single centre experience.

J Otol 2021 Jan 29;16(1):22-26. Epub 2020 Jul 29.

Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia, 5100, Tunisia.

Introduction: Necrotising otitis externa (NOE) is a rare infection of the ear canal with frequent bone erosion. This study's objective is to describe the different features of NOE as well as its management in an ear-nose-throat department. We also tried to identify the particularities of the fungal infection.

Patients And Methods: It is an observational cohort that included all the patients hospitalised for the management of NOE. The study was carried out in the ear-nose-throat Department of Mahdia University Hospital in Tunisia between January 2006 and december 2019.

Results: A total of 40 patients were included. The mean age was 65 ± 12.9 years and the sex ratio was 0.9. Ninety percent of the patients included were diabetics. The most common signs found were oedema of the external canal (97.5%) and auricular discharge (92.5%). The main pathogen isolated was (61.7%). Fungi were isolated in 9 cases (26.47%). Computed tomography was performed for 32 patients (80%). Bone erosion was seen in 26 cases (81.3%). The main complications were cerebral venous thrombosis, retropharyngeal abscess and cerebral empyema. Thirty one patients received only antibiotics, 2 received only antifungal treatment, and 7 received both antibiotics and antifungal treatment. All patients had a favorable outcome. Univariate analysis showed a higher median erythrocyte sedimentation rate was associated with fungal infections. No other differences were noted.

Conclusion: Our management protocol seems to be efficient since all patients had initial favorable outcome. A higher median erythrocyte sedimentation rate was associated with fungal infections.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.joto.2020.07.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7814081PMC
January 2021

Rapid diagnostic tests : Pros, cons and potential use in the COVID-19 management in Tunisia.

Tunis Med 2020 Aug-Sep;98(8-9):639-642

Objectives: Diagnosis of SARS-CoV-2 infection is a major public health issue. In a context of limited diagnostic capacity with the reference technique (real-time RT-PCR), many manufacturers have developed rapid diagnostic tests (RDTs). Although very promising in theory, these tests have raised many questions. This article is a rapid review that synthesizes data regarding different types of available RDTs, their performance, their limits and their potential indications in Tunisia as proposed by a multidisciplinary group of experts.

Methods: A literature review was carried out on the websites of international organizations, governmental bodies and on INAHTA database, completed by a search of relevant scientific articles up to 1 June 2020. The synthesis of the data was submitted to a panel of experts to propose recommendations for the Tunisian context.

Results: RDTs based on the detection of antigens and antibodies have sensitivity and specificity related issues. Few validation reports are published in the scientific literature. Pending more evidence on their performance and validity, several international organizations recommend their use only for research purposes. TDRs based on antibody detection are not appropriate for the early diagnosis of COVID-19. However, validated and specific tests could provide complementary diagnostic information to reference tests.

Conclusion: Pending further evidence, the panel recommends the use of RDTs mainly for research purposes at the community level.
View Article and Find Full Text PDF

Download full-text PDF

Source
March 2021

Advocacy for Increased International Efforts for Antimicrobial Stewardship Actions in Low-and Middle-Income Countries on Behalf of Alliance for the Prudent Use of Antimicrobials (APUA), Under the Auspices of the International Society of Antimicrobial Chemotherapy (ISAC).

Front Med (Lausanne) 2020 25;7:503. Epub 2020 Aug 25.

Aberdeen Royal Infirmary, Aberdeen, United Kingdom.

Antimicrobial stewardship (AMS) is a set of coordinated strategies to improve the use of antimicrobials, to enhance patient outcomes, reduce antimicrobial resistance, and decrease unnecessary costs. The pioneer years of AMS were restricted to high-income countries (HIC), where overconsumption of antibiotics was associated with emergence of multidrug-resistant (MDR) bacteria. AMS in low- and middle-income countries (LMIC) is also necessary. However, programs effective in HIC may not perform as well in LMIC, because (i) While decreased consumption of antibiotics may be an appropriate target in overconsuming HIC, this may be dangerous in LMIC, where many patients die from the lack of access to antibiotics; (ii) although AMS programs in HIC can be designed and monitored through laboratory surveillance of resistance, surveillance programs are not available in many LMIC; (iii) the heterogeneity of health care systems implies that AMS programs must be carefully contextualized. Despite the need to individually tailor AMS programs in LMIC, international collaborations remain highly valuable, through the dissemination of high-quality documents and educational material, that may be shared, adapted where needed, and adopted worldwide. This process, facilitated by modern communication tools, combines many benefits, including: (i) saving time, a precious dimension for health care workers, by avoiding the duplication of similar works in different settings; (ii) taking advantage of colleagues skills, and initiatives, through open access to the work performed in other parts of the world; (iii) sharing experiences, so that we all learn from each others' successes and failures.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3389/fmed.2020.00503DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479847PMC
August 2020

SARS-CoV-2 infection virological diagnosis.

Tunis Med 2020 Apr;98(4):304-308

SARS-CoV-2 infection has to be confirmed by virological diagnosis. Multiple diagnostic tests are available without enough perspective on their reliability. Therefore, it is important to choose the most suitable test according to its sensitivity and specificity but also to the stage of the disease. Currently, the RT-PCR detection of the viral genome in respiratory samples is the most reliable test to confirm the diagnosis of an acute SARS-CoV-2 infection. It has to be done in Class II biological safety laboratory. However, it may lack sensitivity, particularly in the advanced phase of infection, and depends closely on the samples' quality. Rapid PCR by cartridge system reduces response times but is not suitable for laboratories with high throughput of requests. Detection of virus antigens on respiratory samples is a quick and easy to use technique; however it has not good specificity and sensitivity and cannot be used for diagnosis and patient management. The detection of specific antibodies against SARS-CoV-2 is better used for epidemiological analyses. Research should be encouraged to overcome the limits of the currently available diagnostic tests.
View Article and Find Full Text PDF

Download full-text PDF

Source
April 2020

The use of benzathine penicillin in streptococcal erythema nodosum: May it reduce recurrence?

Presse Med 2019 Oct 11;48(10):1180-1182. Epub 2019 Nov 11.

Fattouma Bourguiba Hospital, Infectious Disease Department, 5000 Monastir, Tunisia.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.lpm.2018.10.022DOI Listing
October 2019

Successful treatment of postoperative multidrug-resistant Acinetobacter baumannii meningitis by tigecycline.

J Glob Antimicrob Resist 2016 Jun 21;5:62-3. Epub 2015 Dec 21.

Department of Infectious Diseases, Fattouma Bourguiba Hospital, Farhat Hached Street 5000, Monastir, Tunisia.

Tigecycline is a broad-spectrum antibiotic with activity against multidrug-resistant (MDR) bacteria. It has limited indications. Studies are necessary to elaborate new guidelines. Here we report a case of postoperative MDR Acinetobacter baumannii meningitis treated by tigecycline combined with colimycin for 21 days. The treatment was well tolerated with a favourable outcome. In conclusion, tigecycline was shown to be effective in a case of MDR A. baumannii meningitis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jgar.2015.12.003DOI Listing
June 2016

Management of febrile urinary tract infection among spinal cord injured patients.

BMC Infect Dis 2016 Apr 16;16:156. Epub 2016 Apr 16.

Infectious Disease Unit, Bretonneau University Hospital, Tours, France.

Background: Urinary tract infection (UTI) among patients with neurogenic bladder is a major problem but its management is not well known. We studied the relationship between antibiotic regimen use and the cure rate of those infections among 112 patients with neurogenic bladder.

Methods: We studied a retrospective cohort of febrile UTI among patients with neurogenic bladder. Drug selection was left to the discretion of the treating physicians, in accordance with current guidelines. Patients were divided into 3 groups according to antibiotic treatment duration (<10 days, between 10 and 15 days, and >15 days). We analysed clinical and microbiogical cure rate one month after the end of antibiotic treatment.

Results: The three groups of patients were similar, especially in terms of drug treatment (equal distribution). The cure rates were not significantly different (71.4 %, 54.2 %, and 57.1 %, respectively; p = 0.34). Moreover, there was no difference in cure rate between mono and dual therapy (44 % for monotherapy vs. 40 % for dual therapy; p = 0.71).

Conclusion: This descriptive study supports the efficacy of antimicrobial treatment duration of less than 10 days and the use of monotherapy to treat febrile UTI among patients with neurogenic bladder. A randomized control trial is required to confirm these data.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12879-016-1484-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833936PMC
April 2016

[Diagnostic and therapeutic management of lymph node tuberculosis in Tunisia].

Pan Afr Med J 2014 27;19:211. Epub 2014 Oct 27.

Service de Maladies Infectieuses, CHU Fattouma Bourguiba, 5000 Monastir, Tunisie.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.11604/pamj.2014.19.211.5213DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4372307PMC
November 2015

Hypersensitivity syndrome induced by anticonvulsants: possible cross-reactivity between carbamazepine and lamotrigine.

J Clin Pharmacol 2009 Dec 1;49(12):1488-91. Epub 2009 Sep 1.

Laboratoire de Pharmacologie, Faculté de Médecine de Monastir, Rue Avicenne, 5019 Monastir, Tunisia.

A 14-year-old male presents with erythroderma and fever 44 days after carbamazepine intake. Laboratory exams show eosinophilia and elevated liver enzymes, and thoracic imaging reveals interstitial pneumonitis. All symptoms disappear after carbamazepine withdrawal. A patch test to carbamazepine performed 6 weeks after recovery is positive. About 8 months later, the patient exhibits the same clinical and biological picture 52 days after lamotrigine intake. Lamotrigine is stopped and all symptoms disappear. A patch test to LMG is positive. This case illustrates a possible cross-reactivity between carbamazepine and lamotrigine, which are aromatic and nonaromatic anticonvulsants, respectively.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/0091270009344985DOI Listing
December 2009

[Streptococcus agalactiae in nonpregnant adults].

Tunis Med 2006 Mar;84(3):161-4

Laboratoire de Microbiologie, CHU Farhat Hached Sousse, Tunisie.

Unlabelled: The pathogenic capacity of streptococcus agalactiae or Group B Streptococcus (GBS) has been increasing in nonpregnant adults. We carried out a study about the pathogenic capacity and susceptibility to antibiotics of GBS strains isolated between January 2003 and June 2004 in Farhat Hached hospital of Sousse (Tunisian general hospital).

Methods: Identification of strains was carried out according to usual bacteriological characters. Susceptibility of GBS to antibiotics was carried out according to CA-SFM recommendations.

Results: during the study period, sixty strains were isolated. They were essentially isolated from the urinary tract (52%) and the skin (36.2%). Women accounted for 68 percent of the cases. Among the 30 hospitalized patients, 20 (66%) had serious underlying disease. Diabetes mellitus was predominant (80%). All group B streptococci isolates were susceptible to amoxicillin, penicillin G, vancomycin and to pristinamycin. Sixty four percent of isolates were susceptible to erythromycin. Among the invasive infection, caused by GBS in nonpregnant adults, skin and urinary tract infections were the most common. All isolates were susceptible to amoxicillin, penicillin G. vancomycin and to pristinamycin.
View Article and Find Full Text PDF

Download full-text PDF

Source
March 2006

[Infectious urgencies in an emergency medical service].

Tunis Med 2005 Jan;83(1):18-23

Service des Maladies Infectieuses. E.P.S Monastir.

The aim of this study is to evaluate the frequency of infectious urgencies and the quality of their management in an emergency medical service. During the period of study, 21737 consultants are recorded, from which 2011 for an infectious urgency (9,25%), pharyngitis with rhinitis excluded. 692 patients are hospitalized and 1074 receive ambulatory antibiotics. Therapeutic urgencies are the most frequent infectious urgencies (48,4%), followed by protection urgencies (46,3%), urgencies due to antibiotics (5,2%) and prevention urgencies (0,1%). The conduct is considered correct for 1379 cases (68,5%) and incorrect for 500 cases (25%). Main incorrect conducts are the absence of follow-up (81,6%) and the maladjusted antibiotherapy (11,8%). These results incite, mainly, to the improvement of the professional training of emergency physicians and their communication with their colleagues of the other sanitary structures.
View Article and Find Full Text PDF

Download full-text PDF

Source
January 2005
-->