[Extensive bone marrow necrosis as presenting manifestation of sickle cell disease in Africa]. / Necrose médullaire etendue en Afrique révélant une drépanocytose homozygote.

Extensive bone marrow necrosis is a rare but severe complication of sickle cell disease. A formerly healthy man was admitted for bone pain, fever, and jaundice with severe aregenerative anemia. Bone marrow aspiration and biopsy showed extensive bone marrow necrosis while hemoglobin electrophoresis demonstrated homozygotic sickle cell disease. Despite early onset of septic arthritis of the right shoulder, outcome after blood transfusion and nonspecific treatment was favorable. Six months later, hemoglobin level remained stable up to 97 g/L. This first African case report illustrates typical features and good prognosis of extensive bone marrow necrosis in sickle cell disease. Extensive bone marrow necrosis is a highly unusual presenting manifestation of sickle cell in an adult.

Necrose medullaire etendue en Afrique revelant une drepanocytose homozygote

Extensive bone marrow necrosis is a rare but severe complication of sickle cell disease. A formerly healthy man was admitted for bone pain; fever; and jaundice with severe aregenerative anemia. Bone marrow aspiration and biopsy showed extensive bone marrow necrosis while hemoglobin electrophoresis demonstrated homozygotic sickle cell disease. Despite early onset of septic arthritis of the right shoulder; outcome after blood transfusion and nonspecific treatment was favorable. Six months later; hemoglobin level remained stable up to 97 g/L. This first African case report illustrates typical features and good prognosis of extensive bone marrow necrosis in sickle cell disease. Extensive bone marrow necrosis is a highly unusual presenting manifestation of sickle cell in an adult

[Pulmonary strongyloidiasis complicated by E. coli meningitis in a HIV-1 and HTLV-1 positive patient]. / Anguillulose pulmonaire compliquée d'une méningite à E. coli chez un patient VIH1 et HTLV1 positif.

INTRODUCTION: Disseminated strongyloidiasis occurs in immunodepressed patients, notably those infected by retroviruses. OBSERVATION: A pulmonary strongyloidiasis, complicated by an Escherichia coli meningitis, occurred in a patient exhibiting seropositivity HIV1 for the past year. The status of cell immunity, with 354 lymphocytes T CD4+/mm3, could not explain this severe complication. This led to the diagnosis of an HTLV1 infection. The strongyloidiasis was treated with two cycles of ivermectine, which cured the patient. COMMENTS: In HIV-infected patients exhibiting severe strongyloidiasis, research for an HTLV co-infection is recommended.