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Résumé Justificatif Les données relatives à la pneumonie à Pneumocystis en Afrique sub-saharienne ne sont pas bien connues. La faiblesse du plateau technique et l’utilisation d’outils de diagnostic biologique peu sensibles sont parmi les raisons évoquées. L’objectif de cette étude est de réactualiser les données de l’affection au centre hospitalier universitaire de Fann à Dakar et d’évaluer les méthodes de diagnostic biologique utilisées. Matériel et méthodes Une étude prospective descriptive est réalisée du 5 janvier 2009 au 31 octobre 2011 au service de parasitologie-mycologie du centre hospitalier universitaire de Fann à Dakar. Les prélèvements du liquide de lavage broncho-alvéolaire reçus au laboratoire sont examinés au microscope par immunofluorescence indirecte ou après coloration au Giemsa ou au bleu de toluidine O pour la mise en évidence de Pneumocystis jirovecii. Résultats Cent quatre-vingt-trois prélèvements de liquide de lavage broncho-alvéolaire provenant de 183 patients sont reçus au laboratoire. Seize sont positifs pour la recherche de P. jirovecii , soit une fréquence de 9 %. Quatre parmi eux sont infectés par le VIH. L’immunofluorescence indirecte a permis de retrouver P. jirovecii chez les 16 patients alors que la coloration au Giemsa n’a détecté P. jirovecii que chez un seul patient. Aucun cas n’est diagnostiqué par le bleu de toluidine O. Conclusion La pneumonie à Pneumocystis au laboratoire de parasitologie-mycologie du centre hospitalier universitaire de Fann à Dakar est majoritairement diagnostiquée chez des patients infectés par le VIH. Summary Background Data relative to Pneumocystis pneumonia in sub-Saharan Africa are not well known. Weakness of the technical material and use of little sensitive biological tools of diagnosis are among the evoked reasons. The objective of this study is to update the data of the disease at the Fann Teaching Hospital in Dakar and to estimate biological methods used in diagnosis. Materials and methods A descriptive longitudinal study was carried out from January 5th, 2009 to October 31st, 2011 in the parasitology and mycology laboratory of the Fann Teaching Hospital in Dakar. The bronchoalveolar lavages received in the laboratory were examined microscopically for Pneumocystis jirovecii by indirect fluorescent assay or after Giemsa or toluidine blue O staining. Results One hundred and eighty-three bronchoalveolar lavages withdrawn from 183 patients were received in the laboratory. Sixteen were positive for P. jirovecii at 9% frequency. Four among these patients were HIV positive. Indirect fluorescent assay allowed finding of P. jirovecii among 16 patients while Giemsa staining discovered P. jirovecii only in a single patient. No case was diagnosed by toluidine blue O staining. Conclusion Pneumocystis pneumonia in Parasitology and Mycology Laboratory of Fann Teaching Hospital at Dakar was mainly diagnosed among HIV patients. [ABSTRACT FROM AUTHOR]

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Abstract: Objectives. – This retrospective study was carried out to determine the prevalence of cerebromeningeal diseases at the Fann Teaching Hospital Infectious Diseases Clinic, in Dakar, and to describe their epidemiological, clinical, and etiological features. Patients and methods. – Data was collected for analysis from patients files recorded from January 1, 2001 to December 31, 2003. Results. – Four hundred seventy cases were identified (11.4% of total admissions) with a M/F sex ratio of 1.38 and a mean age of 33 years. Eighty-nine patients were infected by HIV and clinical presentations included fever (78%), meningeal syndrome (57.4%), coma (64.9%), convulsions (19%), focal neurological deficits (15.5%), and cranial nerves dysfunction (7.2%). Etiologies presented as cerebral malaria (85 cases), purulent meningitis (51 cases), neuromeningeal cryptococcosis (37 cases), tuberculous meningitis (11 cases), intracranial abscess (10 cases), toxoplasma encephalitis (4 cases), cerebrovascular attack (11 cases), and cerebromeningeal hemorrhages (3 cases). In as many as 248 cases (52.8%) no etiology could be found. The case fatality rate was 44.5% overall (209 deaths) and 68.5% among HIV-infected patients. Neurological sequels were found in 22 survivors (8.8%), consisting in focal neurological deficit (12 cases), deafness (5 cases), diplopia (2 cases), dementia (2 cases), postmeningitic encephalitis (1 case). Conclusion. – These results show the need to improve our technical capacities in our diagnostic laboratories, the prevention of opportunistic infections in the course of HIV/AIDS infection, and the involvement of various specialists in the management of cerebromeningeal diseases. [Copyright &y& Elsevier]