[Disseminated strongyloidiasis, a rare cause of multiple organ failure]. / L'anguillulose maligne, cause rare de défaillance multiviscérale.

INTRODUCTION: Strongyloidiasis is an parasitic intestinal disease, frequent in tropical countries and fairly rare in temperate areas under certain conditions. Disseminated forms can provoke multivisceral damage. CASE REPORT: A 75 year-old woman, hospitalized for occlusion, developed multivisceral (cerebral, renal, cardiac pulmonary and hepatic) damage over 48 hours, attributed to strongyloidiasis. The diagnosis was confirmed by isolation of larvae in the tracheal and gastric aspiration fluids. Treatment combined ivermectin and albendazole. COMMENTS: Disseminated stronglyloidiasis is essentially observed in immunodepressed patients, under corticosteroids or HTLV1 carriers, although an HIV status does not appear to intervene. Larvae can be found in all the organs. Death occurs by multivisceral failure in 50 to 70% of cases. Broncho-alveolar washing and examination of the gastric fluids is the key to diagnosis. Treatment relies on thiabendazole, ivermectin or albendazole, and the symptomatic management of all the visceral deficiencies.

[Campylobacter fetus ssp fetus septicemia associated with a colonic abscess]. / Septicémie à Campylobacter fetus ssp fetus associée à un abcés colique.

Campylobacter is considered to be an opportunistic agent. The authors relate an unusual case with Campylobacter fetus ssp fetus (CF) septicemia and colic abscess. Human Campylobacteriosis is presumed to be a food-born disease related to contaminated animal products such as milk or meat. In some cases CF may be transmitted by drinking water or by fecal soiling via the hands. Conventional treatment uses macrolides with decrease the duration of diarrhea and reduce the fecal excretion of CF. Macrolides are ineffective in CF septicemias. In such cases aminoglycosides seem to be the drug of choice.

Non-cardiac pulmonary edema following intravenous contrast injection.

Acute non-cardiogenic pulmonary edema (NCPE) following intravenous administration of contrast media is a rare but life-threatening complication of radiologic contrast material. We recently observed this complication as an idiosyncratic reaction following a coelio-mesenteric arteriography.

[The locked-in syndrome]. / Le syndrome de verrouillage.

The locked-in syndrome is poorly understood, and may be misdiagnosed as coma. The syndrome consists of complete paralysis of all four limbs and the lower cranial nerve pairs, associated with an unaltered consciousness. Vertical eye movements and blinking remain intact, so allowing some form of communication by way of eye codes. Obstruction of the vertebral and basilar vascular system is the major cause, but the six cases reported show the aetiological diversity of this syndrome. If the vascular obstruction is diagnosed within the first few hours, fibrinolytic therapy may be considered. Although the patients usually die within a few days or after several months, some rare cases of recovery after several weeks have been reported. Intensive care is required by these patients (tracheostomy, artificial ventilation, intensive nursing care); the physicians and nursing staff looking after them should always keep in mind that these patients are conscious and able to communicate.