[Community pneumonia Klebsiella pneumoniae producing beta-lactamase with extended spectre]

Klebsiella pneumoniae is the prerogative of nosocomial infections. Rarely Community lung infection by a strain of Klebsiella pneumoniae producing extended-spectrum beta-lactamase have been reported. We report a case of a case of pyopneumothorax due to infection by Community Klbsiella pneumoniae producing extended spectrum beta lactamase in a young patient of 29 years bacteriological examinations of pleural fluid drainage made the admission of the patient during his stay in intensive care have resulted in a K pneumoniae isolate producing extended spectrum beta lactamases. Despite treatment with imipenem and colistin prescribe 48 hours after admission of our patient, the evolution was fatal with death of the patient in an array of multi-visceral failure at 21 days of hospitalization. The isolation of an extended-spectrum beta-lactamase strain is often responsible for a fatal outcome, think about when you're facing a particular field, in the presence of risk factors such as outpatient antibiotic where the need 'control' strategy

[Incidence and risk factors of nosocomial infections in gravelly traumatised patients]

To evaluate the incidence and the risk factors of the nosocomial infections [NT] in gravelly traumatized patients. It is a retrospective study of 6 months concerning a cohort of patients admitted in resuscitation department for a grave traumatism [ISS >/= 15]. The risk factors of NI were studied in univariate and multivariate analyses. The study included 55 patients [54 men and 1 woman], the average age was 36 +/- 13 years, the ISS of 19.3 +/- 3. The incidence of NI was 49%, the pulmonary localization was most frequent [81%]. The variables related to occurrence of NI in the gravelly traumatized patients were a low GCS [p<0.001], an associated cranial traumatism [p = 0.004], high scores of gravity: IGS II [p = 0.04], APACHE 11[0.01] and ISS [p = 0.006], the recourse [p = 0.001] and the duration of artificial ventilation [p<0.0001]. The logistic regression retained two independent variables: the low GCS [OR: 3.9; IC95% = 1.6 - 88; p = 0.011. In this work the incidence of NI in of a gravelly traumatized patients was high [49%], it was dominated by the pulmonary localization. The low GCS and the duration of artificial ventilation were independent risk factors

[Cerebral toxoplasmosis revealing a neuro-Aids]

Cerebral infection to toxoplasmosis is an opportunist infection. Its radiological aspect is not specific. It concernes male patient of 38 years old, treated from Crohn disease since three months, who was presented by infectious intracranial hypertension syndrome, symptomatic treatment was prescribed. In front his clinical aggravation, a multiple intracranial MRI was done, which showed a miliary encephalitis. Tubercolous origin was thought of and the patient received an anti-tubercolous treatment. Secondary, stereotaxic biopsy and biological study showed an advanced stage of toxoplasmosis infection reveals to a neuro-Aids. Through this observation, the authors paid an attention to think always in the eventuality of neuro-Aids in front of cases of miliary encephalitis

[Thrombocytopenia associated with low molecular weight heparin about one case]

Because of material infection, one 74 years old patient underwent total hip replacement ablation. After infection recovely, the patient has been treated with Lovenox for 12 days to plevent venous thrombosis; routine Laboratory studies revealed thrombocytopenia [34.000/mm3]. At the same time has appeared an hemorrhagic syndrom [petechiae, ecchymosis and total hematuria]. Prothrombin time, partial thromboplastin time remained normal. Lovenox was discontinued, the thrombocyte count returned to normal after 6 days. The literature concerning this topic is reviewed and discussed