Журнал клинических и экспериментальных дерматологических исследований
Открытый доступ

Абстрактный

Comparative Study of Necrotizing Bacterial Dermohypodermitis or Necrotizing Fasciitis Depending on the HIV Serostatus in Abidjan (Cote d Ivoire)

Ecra Elidjé Joseph, Kouassi Yao Isidore, Gbéry Ildevert Patrice, Sangaré Abdoulaye, Kourouma Sarah, Kouassi Alexandre, Djadji A Thierry Lenoir, Kassi Komenan, Djéha Djokouehi, Kaloga Mamadou and Ahogo Kouadio Celestin

Introduction: HIV infection modifies ordinary epidemiological, clinical and progressive aspects of infectious diseases. Moreover, in Sub-Saharan Africa owing to the fact that people consult health centers at a late stage of the disease, such pathologies are subject to modification. This applies to necrotizing bacterial dermohypodermitis or necrotizing fasciitis. This study was conducted in order to compare epidemiological, clinical and progressive aspects of patients with necrotizing bacterial dermohypodermitis or necrotizing fasciitis depending on their HIV status.

Tools and methods: This was a retrospective descriptive and analytic study on patients admitted into hospital from January 1, 2005 to December 31, 2011 at the Department of Dermato-venerology of the Teaching Hospital of Treichville. We included patients admitted into hospital over that period for Necrotizing Bacterial Dermohypodermitis or Necrotizing Fasciitis who knew their HIV status.

Results: Over this period of 7 years, 235 cases of necrotizing bacterial dermohypodermitis or necrotizing fasciitis were recorded i.e. 34 cases per year. HIV serostatus was conducted in 83 patients (35.3%) of whom 37 HIV positive (44.6%) and 46 HIV negative (55.4%). The average age of HIV positive patients was statistically lower (40.97 years) than that of HIV negative patients (51.99 years) (P=0.0015). Lower limbs were the main sites in HIV positive patients (93.93%) as well as in HIV negative patients (95.55%). There is no significant difference as related to atypical sites. HIV positive patients developed more complications (16 cases) than HIV negative patients (05 cases) with P=0.000004. These complications were mainly septicemia (62.5%) of HIV positive patients whereas scabs (60%) were more frequent in HIV negative patients. The death rate was statistically higher in HIV positive patients (29.72%) than in HIV negative patients (2.17%) with P=0.00038. Conclusion Necrotizing Bacterial Dermohypodermitis or Necrotizing Fasciitis associated with HIV affected relatively young people. Apart from the evolution related to the late treatment with a high death rate in HIV positive patients, clinical signs were less modified depending on the serological status in our contexts.