[Ecthyma gangrenosum and Pseudomonas aeruginosa septicemia in intensive care unit]. / Ecthyma gangrenosum et septicémie àPseudomonas aeruginosa en réanimation.

We report a case of a Pseudomonas aeruginosa septicemia complicated by a septic shock after chemotherapy for pulmonary cancer. Bilateral legs necrotic purpura corresponding to echtyma gangrenosum lesions (erythematous inflammatory halo, positive bacteriologic cutaneous biopsy) was noted 48 h previous to the shock. Echtyma gangrenosum manifestation should alert physician to P. aeruginosa septicemia risk and can be useful to guide probabilist antibiotherapy.

Hemorrhagic leukoencephalitis linked to Epstein-Barr virus in an adult patient.

We report a case of an adult patient who presented a febrile coma linked to Epstein-Barr virus (EBV) encephalitis. EBV polymerase chain reaction (PCR) was positive in cerebrospinal fluid (CSF) and blood serology and PCR in blood was consistent with an EBV reactivation. First cerebral magnetic resonance imaging (MRI) at day 1 was normal but a second MRI at day 13 showed anomaly compatible with a hemorrhagic leukoencephalitis. Treatment consists of intravenous corticotherapy and aciclovir during 21 days. Evolution was favourable with complete neurologic recuperation and no intercurrent lymphoma or vasculitis in 6 months follow-up.

[Repeated intestinal tract perforations secondary to cryoglobulinemia and cytomegalovirus infection: a case report]. / Perforations digestives itératives secondaires à une cryoglobulinémie essentielle et au cytomégalovirus : à propos d'un cas.

Cryoglobulinemia associated vasculitis is usually related to hepatitis C virus. Clinical features include purpura, glomerulonephritis, or peripheral neuropathy. Intestinal involvement in cryoglobulinemia is rare and has a poor prognosis. It often leads to a therapeutic with immunosupressive drugs. The related immunodepression exposes to a reactivation of cytomegalovirus (CMV) infection that may also be potentially responsible for intestinal injury. We report a 68-year-old man who presented with iterative intestinal perforations secondary to a cryoglobulinemia vasculitis and then to a CMV infection.

[Adult onset nemaline myopathy revealed by respiratory insufficiency]. / Révélation d'une myopathie à bâtonnets par une insuffisance respiratoire de l'adulte.

INTRODUCTION: We report a case of nemaline myopathy revealed in adulthood by a respiratory insufficiency. CASE REPORT: A 26-year-old patient, without past history, was admitted with respiratory and right cardiac insufficiency which appeared in a few days. There was a severe restrictive lung impairment with nocturnal hypoventilation. Minor skeletal abnormalities and areflexia suggested a congenital myopathy. Muscle biopsy revealed a nemaline myopathy. CONCLUSION: Respiratory insufficiency is common in nemaline myopathy with infancy or childhood onset, but very rare in adults. It may be explained by multiple mechanisms.

International comparison of awareness and attitudes towards coronary risk factor reduction: the HELP study. Heart European Leaders Panel.

BACKGROUND: An international survey was conducted to assess public awareness and attitudes to coronary heart disease and to establish the frequency with which certain health-related behaviours are practised in five European countries. METHODS: Members of the general public (n=5013), individuals at increased risk of coronary disease (n=2500), patients who had suffered a myocardial infarction (n=1256) and members of their families (n=1249) were interviewed in a study conducted in France, Germany, Italy, Sweden and the UK. Questions were asked about respondents' attitudes to their health and about their current health practices. RESULTS: The survey revealed a considerable degree of indifference to coronary heart disease, despite the possession of a reasonable level of knowledge of the risks involved, even among patients who had suffered a myocardial infarction. At the same time, respondents declared themselves satisfied with the quality of advice about coronary health that they obtained from the medical profession and regarded these sources of information as highly credible. Media health campaigns, by contrast, had comparatively little impact. CONCLUSION: A survey of five European countries shows that individuals possess reasonable levels of knowledge about coronary heart disease. They also have access to sources of heart health information that are perceived as highly credible. Nonetheless, such information has a very limited impact on their practice of health-related behaviours.