Streptococcus bovis endocarditis: Clinical, Echocardiographic and prognostic features.

The aim of this study was to determine clinic and echocardiographic characteristics of Streptococcus bovis endocarditis [El] and its prognosis. We studied the clinic and echocardiographic characteristics of 54 patients with a Streptococcus bovis El among 350 cases of El. We included 44 men and 10 women, 64 +/- 15 years of age, with a native valvular disease in 31.5% of cases and a valvular prosthesis in 13%. 74% had a worsened general state; 48% presented with signs of cardiac insufficiency. 12 patients [22%] were followed for cancer including 7 digestive colic localizations [confirmed by coloscopy and histology]. Vegetation was identified in all patients. It was a left localization in 98.1%. Vegetation diameter was>10 mm in 37 patient s [68.5%] and>20 mm in 9 patients [16%]. During the follow-up, 59.3% developed an embolic accident, 17 cases of CVA and 7 cases of spondylodiscitis [7 out of 11 cases of spondylodiscitis described in the 350 cases of El]. Mortality reached 7%. The statistical analysis showed that Streptococcus Bouis was the major predictive factor for embolic complications, especially for spondylodiscitis. Streptococcus bovis El is more frequent in patients with digestive colic neoplasia. It is characterized by large vegetation which has a high embolic potential worsening the prognosis

[Fibrodysplasia ossificans progressiva. about one case]

Myositis ossificans progressiva is a rare autosomal dominant progressive disease of connective tissue. It consists on a heterotopic osteogenesis frequently associated to characteristic congenital malformations. We report a case of a 12-year-old girl which presented a heterotopic bone formation leading gradually to ankylosis. The diagnosis was suggested when we have discovered bone bridges between the rib cage and the superior limbs. Congenital malformations, most commonly of big toes and thumbs, are important criteria to draw on the diagnosis earlier and to avoid unnecessary biopsy or resection which may trigger off a flare of the disease. Therapeutic measures are essentially preventive and the prognosis is poor

[Retinal artery occlusion as part of susac's syndrome]

We report a single case of Susac's syndrome wich is a microangiopathy of the brain, retina and cochlea. A 45 years old women developed central retinal artery occlusion in the left eye, associated with bilateral hearing loss that mostly involved low and middle frequencies. MRI of the brain revealed numerous under-cortical, paraventricular and callous lesions. The treatment consisted of anticoagulation and antiplatelet drugs