Research Article
Patterns of Microbial Infections in Post-Infective Hydrocephalus and Treatment Methods at Bugando Medical Center
James Lubuulwa*
,
Vitus Silago
Issue:
Volume 8, Issue 2, December 2024
Pages:
22-27
Received:
4 June 2024
Accepted:
21 June 2024
Published:
20 September 2024
Abstract: Background: Post Infective Hydrocephalus is among the complicated types of hydrocephalus and poses a challenge in management of these patients, globally. Antibiotics susceptibility patterns of common bacteria implicating in pyogenic ventriculitis complicated with hydrocephalus were not clearly known at our setting. Therefore, we determined antibiotics susceptibility patterns of common bacteria implicating in pyogenic ventriculitis complicated with hydrocephalus to recommend empirical therapy while waiting for culture and sensitivity results at Bugando Medical Centre (BMC) in Mwanza, Tanzania. Methods: Thirty-five patients with hydrocephalus who had undergone cerebrospinal fluid (CSF) tapping and analysis were selected randomly retrospectively and their bacteriological culture and sensitivity results were analyzed to determine the common microbial patterns. Patients were rationally prescribed antibiotics depending on laboratory results for 7 days and were later done control CSF cultures until negative cultures were achieved. Results: A total of 35 patients with median (interquartile range [IQR]) age was 5.5 [2-8] months were reviewed. The majority of participants were males, 62.9% (22/35). 20% (7/35) and 37.1% (13/35) had turbid CSF-shunt sample and first culture positive results, respectively, whereas one patient had culture positive with two pathogens resulting to 14 isolates. Gram positive bacteria were predominantly isolated (66.7%, 8/14), whereby S. aureus was frequently encountered (35.7%, 5/14). Overall, gram positive and negative bacteria exhibited least resistance against tetracycline (16.7% and 25%) and ciprofloxacin (16.7% and 25%) respectively. Three (8.6%) patients died from respiratory complications. Conclusion: Post infective hydrocephalus is a clinically challenging but treatable form of hydrocephalus and Staphylococcus aurous is the most common cause. This study found that the use of a seven-day regimen as cost effective and associated with a shorter hospital stay with the focus on CSF analysis with subsequent microbial targeted antibiotic therapy to achieve sterile CSF culture. Treatment strategy should be multidisciplinary approach with collaboration from microbiologists, radiologists, pediatricians and neurosurgeons.
Abstract: Background: Post Infective Hydrocephalus is among the complicated types of hydrocephalus and poses a challenge in management of these patients, globally. Antibiotics susceptibility patterns of common bacteria implicating in pyogenic ventriculitis complicated with hydrocephalus were not clearly known at our setting. Therefore, we determined antibiot...
Show More
Research/Technical Note
Surgical Treatment of Craniocervical Junction Tumors: Neurosurgery Department Experience of “Hôpital Principal De Dakar”
Issue:
Volume 8, Issue 2, December 2024
Pages:
28-34
Received:
6 August 2024
Accepted:
2 September 2024
Published:
23 September 2024
Abstract: Introduction: Craniocervical tumors are uncommon but represent a medical emergency for diagnosis and treatment. Their approaches require of course surgical expertise in addition to adapted technical platform. In light of the limited resources available in our practice, we consequently made the decision to share our experience with the surgical treatment of this pathology. Patients and method: We performed a retrospective analysis on eight observations of patients treated in the neurosurgery department of “Hôpital Principal de Dakar” between July 2015 and December 2022 for progressive tumor spinal cord compression at the craniocervical junction. Results: We observed a 10% frequency, a mean age of 39.25 years, and extremes between 8 and 62 years. There was a 0.6 sex ratio. The most common risk factor was type I neurofibromatosis, and one case of Von Hippel-Lindau disease. All of our patients had pyramidal syndrome. Overall, there were 2 tumors with posterolateral extradural site and 4 tumors with extramedullary intradural location, including 2 posterolateral and 2 anterolateral. The location was intramedullary and cerebella-medullary in one case each. The posteromedial occipitocervical approach, which was employed on six patients, was the most utilized method. Five patients had total tumor resection, whereas three had partial resection. Two of our patients had postoperative complications: a worsening of motor deficit and a death following dependence on mechanical ventilation. We only received four histological confirmations for the anatomopathological samples. Our patients' evolution was positive over an average follow-up of 21 months, with neurological improvement and walking autonomy. Conclusion: Tumors affecting the craniocervical junction are still treated surgically. Despite the need for improvement in our working conditions, our results appear to be satisfactory.
Abstract: Introduction: Craniocervical tumors are uncommon but represent a medical emergency for diagnosis and treatment. Their approaches require of course surgical expertise in addition to adapted technical platform. In light of the limited resources available in our practice, we consequently made the decision to share our experience with the surgical trea...
Show More
Research Article
Knowledge and Practice About Traumatic Brain Injury in the Hospital Environment in the DRC
Issue:
Volume 8, Issue 2, December 2024
Pages:
35-40
Received:
15 April 2024
Accepted:
26 August 2024
Published:
26 September 2024
Abstract: Introduction: Traumatic brain injury (TBI) is a common reason for admission in our setting. It is the cause of primary brain lesions, representing a major public health problem since they are responsible for significant morbidity and mortality. Materials and Methods: Observational study with survey, run from December 1, 2023, to January 31, 2024, involving 256 health workers to verify the level of knowledge about traumatic brain injury. Results: The age group between 21 and 40 years constitutes 64.05% of cases (n=164), The average age is 29.38, with extremes between 24 and 65 years, We note a male predominance in 53.12% of cases (n= 136), Medical Doctors constitute 75% of the medical personnel interviewed (n=192), we note a clear predominance of 0 to 5 years old with 33.59% of cases (n=86), The faculty predominates as the place of learning about head injuries in 53.65% of cases (n=132), The neurosurgeon takes care of the management of craniocerebral trauma in 58.13% of cases (n=143), According to this staff, the biggest problem in the management of head trauma in our environment is the cost of treatment with 62.89% of cases (n=161) and in most cases (54.29% of cases or 139 patients), health personnel consider themselves to have a mean level of understanding of craniocerebral trauma. Conclusion: The management of TBI is currently a diagnostic, therapeutic, and prognostic challenge linked to several factors in our environment. A consensual approach standardized to adapt to our practical reality proves helpful in reducing morbidity and mortality.
Abstract: Introduction: Traumatic brain injury (TBI) is a common reason for admission in our setting. It is the cause of primary brain lesions, representing a major public health problem since they are responsible for significant morbidity and mortality. Materials and Methods: Observational study with survey, run from December 1, 2023, to January 31, 2024, i...
Show More
