[Unusual paralysis: due to black widow bite]

The mediterranean black widow spider is a kind of latrodectus mactans tredecimguttatus. It is found in the Mediterranean basin. Its bite cause a rare syndrome called lactrodectism. A Moroccan patient, aged 17 years old, came to the emergency ward with severe pain in the right chest and fever, insect bites scar at the elbow. The evolution was favorable with antibiotics, antihistamines, and intravenous calcium. The discovery by the family in the patient's room of the spider identified type Latrodectus has consolidated the diagnosis of spider bite. Latrodectus tredecimguttatus is a spider that can be responsible of envenomation in humans. Its bite is almost painless. The alpha-neurotoxin protein latrotoxine is implicated in the onset of symptoms, this symptomatology is polymorphic, including a latrodectismica facies, with or without constitutional symptoms, painful symptoms, cardiovascular signs and digestive signs that represent the most common pattern of consulting and most often a source of diagnostic errors. Latrodectism is a source of frequent misdiagnosis, surgical acute abdomen, colic, tetanus, meningitis, psychosis, myocardial infarction of opiate withdrawal syndrome inducing inappropriate treatment, often detrimental to the poisoned patient. This poisoning, although rare, must be known because if can lead to unnecessary therapeutic procedures, and even be potentially fatal for extremely aged people with extreme ages of life

[Pet scan in internal medicine]

The nuclear medicine techniques represent an important role in infections and inflammation's evaluation. 18-fluorode soxyglucose [18F-FDG] is a tracer of glucose metabolism, recently produced in Morocco, which provides functional sensitive and high resolution images thanks to Positron Emission tomography [PET]. The indications of FDG-PET in internal medicine include the diagnosis management of certain inflammatory diseases, vasculitis of large vessels, such as temporal arteritis, especially in its systemic presentation, and Takyasu's arteritis. It is also useful for staging sarcoidosis, for differential diagnosis and the therapeutic's evaluation in multiple myeloma. The 18-FDG PET is the most effective for the diagnosis of paraneoplastic syndromes, or carcinomas of unknown primary. In case of fever of unknown origin, it facilitates the identification of the site of the infection and guides investigations conducting to the confirmation of the diagnosis. All, situations frequently found in internal medicine. This article will focus on the role of 18-FDG PET in the pathology specific to internal medicine. However, large scale prospective studies are needed before incorporating FDG-PET in clinical routine, because it is expensive and not available in our country

[Management of bone density abnormalities in inflammatory bowel diseases]

Osteoporosis is a common and life-threatening problem in patient with inflammatory bowel diseases. Its management is so very important and must be systematically investigated. The incomplete comprehension of pathogenesis and physiopathology of osteopenia in IBD is source of big difficulties in the treatment of this abnormality. Many advances had been realized last years in the management of osteopenia of IBD. This paper is a review of the physiopathology of low mineral density in patients with IBD and its implications on treatment