[ Pollen-food olive-olive syndrome]

Background: The pollen-foods syndrome is rare and of difficult diagnosis. The aim is to report a rare case, it's the four case reported in the literature

Case report: A 48-year-old woman presenting with palatal itching and generalized urticaria following ingestion of olive fruit, 5 years after being diagnosed with olive pollinosis. She did not have a history of other food allergy or urticaria. The prick-test was positive in olive pollen.The olive pollen specific IgE was positive. The oral provocation test was positive for olives and negative for olive oil. The diagnosis of "pollen-food olive-olive syndrome" was accepted. Interestingly, in this rare case the patient developed olive fruit allergy in the presence of olive pollinosis, but did not experience allergic symptoms to fruits other than olive

Conclusion: In spite its rarity this syndrome should be evoke particularly in our country

[Pulmonary tuberculosis in immunocompetent: causes and consequenses]

Background: Despite scientific advances, extended forms of pulmonary tuberculosis are still relevant. The aim of our study was to determine clinical features and outcome of extended pulmonary tuberculosis in immunocompetent patients

Methods: Retrospective comparative study including 100 patients HIV negative, presenting pulmonary tuberculosis divided into 2 groups of 50 patients [group1: extended tuberculosis and group2: localized tuberculosis]. Tuberculosis was considered extended when reaching above one lobe

Results:The average age was comparable in the 2 groups [p = 0.138]. In group1, we noted a higher incidence of diabetes [p = 0.037] and malnutrition [p = 0.045]. Clinically, patients in group1 had more general signs [p=0.033] and dyspnoea [p=0.037]. Biologically, anemia [p<0.001], leukocytosis [p=0.05], elevated CRP [p=0.031], thrombocytosis [p=0.023], hyponatremia [p = 0.001] and liver disturbances [p = 0.001] were significantly more frequent in group1. Concerning the evolution, time to smear negativity was significantly longer [p=0.012]. Similarly, radiological sequelae were more frequent [p = 0.02] and more extensive [p = 0.012]. Positive predictive value of radiological extent in disease evolution was 62% with a confidence interval between 47.2% and 75%

Conclusions: The extent of pulmonary tuberculosis is an important factor in clinical and biological presentation and disease evolution. Indeed, patients with extended tuberculosis develop more severe presentation and are more likely to develop parenchymal sequelae

[Lung cancer with venous thrombo-embolism: clinical characteristics]

Lung cancer is the most common malignancy diagnosed in patients with venous thrombo-embolism [VTE]. To investigate clinical, biological, radiological features and survival of lung cancer patients with VTE. Retrospective case-control study investigating biologic, clinical course and survival of 25 patients lung cancers with VTE [Group M] and 50 lung cancers without VTE [group T]. The frequency of the VTE was 5.88% with 2.58% pulmonary embolism [PE]. The mean age was 58 years +/- 9.8 in group M and 57.9 years +/- 9.6 in group T. No significant difference concerning medical or surgical history for both groups was found. The dyspnea and chest pain were at equal frequency [63.6%]. Regarding the clinical probability of the PE, it was no significant differences between the two groups. A rate of D-dimer > 0.7micro g/l was more frequent among group M [75% vs 20%; p = 0.054]. The most common histological type was nonsmall cell lung cancer [88%]. A stage IV was significantly more frequent in group M [86.4% vs. 52.3%; p = 0.007]. The mean period of survival in Group M was 10.6 +/- 1.2 month and 20.2 + 1.8 month in group T; p = 0.38. The VTE associated to lung cancer is under diagnosed. Prospective studies are needed to establish more adapted scores

[Benign schwannoma: a case report about a uncommon localization]

Schwannoma is a benign slow growing nerve sheath tumor which generally originates from cranial or spinal nerve roots. Peripheral nerve localisations are scarce. We report the case of a 76-year man who presented with a laterosternal chest wall mass located in the fourth intercostal space. Diagnosis of intercostal benign schwannoma was suggested by medical imaging and confirmed histologicolly upon surgical removal. Chest wall solitary schwannoma is exceptional. Our case is still more interesting by its peripheral localisation and late occurence following a chest trauma

[Reexpansion pulmonary edema a vacuo: a case report and literature review]

Reexpansion pulmonary edema is a rare and potentially lethal complication with a 15 to 20% mortality. We report one case of pulmonary edema after evacuation of spontaneous right pneumothorax The pathophysiology of reexpansion pulmonary edema remains obscure; mechanical and inflammatory processes [production of Inerleukin 8 - and Leukotrienne B4] seem incriminated. Duration and severity of lung collapse and the rate of reexpansion appear to be the main causes justifying preventive measures. Curative treatment is based on oxygenation and lower aspiration pressure