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Resume Introduction Les suppurations intracrâniennes (SIC) sont mal evaluees en Afrique subsaharienne, particulierement chez l’enfant. Patients et methodes Etude retrospective du 1 er janvier 1996 au 31 decembre 2004 chez les enfants admis pour SIC secondaire a une infection otorhinolaryngologique (ORL) a l’hopital Principal de Dakar, Senegal. Seuls ont ete inclus les cas confirmes par tomodensitometrie (TDM). Resultats Seize enfants (12 garcons et 4 filles) d’âge moyen de 11,2 ans (extremes : 7–15 ans), ont ete admis pour SIC en moyenne 12 j (extremes : 1–60 j) apres le debut de la fievre et 6 j (extremes : 1–22 j) apres celui des signes neurologiques. La fievre etait presente 14 fois et les signes neurologiques etaient constants. L’infection initiale etait une sinusite ( n = 14) ou une otite ( n = 2). La SIC etait un empyeme sous-dural ( n = 8), un abces cerebral unique ( n = 6) ou multiple ( n = 1), ou l’association empyeme sous-dural et abces cerebral ( n = 1). L’analyse bacteriologique etait rarement contributive : Staphylococcus aureus ( n = 2), streptocoque non groupable ( n = 2), et association Pseudomonas aeruginosa – Proteus mirabilis ( n = 1). L’antibiotherapie, associee 4 fois a des corticoides et 9 fois au phenobarbital, etait prescrite pendant 2 mois. Une ponction de la SIC a ete pratiquee chez 13 patients. Tous les enfants ont gueri, mais 4 ont garde des sequelles neurologiques. Discussion Cette serie permet de preciser les caracteristiques des SIC chez l’enfant en Afrique subsaharienne et de proposer un protocole therapeutique adapte a ce contexte. Conclusion L’acces a la TDM a ete primordial pour guider la prise en charge medicochirurgicale et permettre une issue le plus souvent favorable, malgre un diagnostic tardif.

Cardiovascular and neurological manifestations associated with thiamine deficiency in Guinean prisons are common but not reported.We performed a prospective study of 38 cases related to vitamin B1 deficiency over a period of 4 years. In this population, the literature of traditional data gathered: frequency peak after thirty (92.6%) and clear representation male (sex ratio M/F: 18/1). The clinical symptomatology remains essentially dominated by sensorimotor polyneuropathy and pure sensory (52.2%), overall heart failure (31.5%) and to a lesser degree by Gayet Wernicke's encephalopathy (7.8%) and shoshin beriberi with severe evolution (5.2%). The study of nutritional status by body mass index (BMI) of the World Health Organization, by the criteria of Detsky and biological markers including albumin, shows that these patients are severely malnourished.

Intracranial suppurations (ICSs) are poorly assessed in sub-Saharan Africa, especially in children.A retrospective study from 1st January 1996 to 31st December 2004 in children admitted to the pediatric department of the Hôpital Principal de Dakar, Senegal, for a sinogenic or otitic ICS. All cases were diagnosed by CT scan.Sixteen children (12 boys and 4 girls), mean age of 11.2 years (range, 7-15 years), were admitted with the primary diagnosis of ICS. The mean time from the beginning of fever or neurological disorders to admission was 12 days (range, 1-60 days) and 6 days (range, 1-22 days), respectively. At admission, fever was noted in 14 patients and neurological signs in all patients. Otolaryngologic infections were sinusitis (n=14) or otitis (n=2). ICSs were subdural empyema (n=8), single (n=6) or multiple (n=1) cerebral abscesses, or association of subdural empyema and cerebral abscess (n=1). Bacteriological cultures were seldom positive because of frequent previous antibiotic therapies and showed Staphylococcus aureus (n=2), nongroupable Streptococcus (n=1), or Pseudomonas aeruginosa and Proteus mirabilis (n=1). Antibiotics were given initially intravenously for 30 days, then orally for 30 days. Additionally, some patients received corticosteroids (n=4) or phenobarbitone (n=9). Aspiration drainage of the ICS was undertaken in 13 patients. All the children were cured, 4 of whom had neurological sequelae at follow-up.This pediatric series provides important data on the characteristics of ICS in sub-Saharan Africa. Therapeutic measures adapted to this context are proposed.Access to CT scan was fundamental in guiding medical and surgical management and ensuring a mostly favorable outcome despite long delays in treatment initiation.