A case report of fungemia due to Kodamaea ohmeri.

BACKGROUND: Kodamaea ohmeri is a yeast is frequently mistaken for Candida, which belongs to the same family. This micro-organism has been reported to cause life-threatening infections in humans. CASE PRESENTATION: A 81-year-old woman developed a severe fungemic pulmonary infection due to Kodamaea ohmeri that was identified from bronchoalveolar fluid and blood cultures, which is unusual in immunocompetent patients. Because K. ohmeri was first wrongly identified as Candida albicans, the patient inadequately received caspofungin, which was clinically ineffective, especially as the strain was resistant to echinocandins. Clinical cure was obtained after treatment was switched to voriconazole. CONCLUSIONS: An increasing number of serious infections due to K. ohmeri has been reported in the literature, but the correct identification of this micro-organism remains difficult.

Forty-eight glomus tumours of the hand. Retrospective study and four-year follow-up.

We report a series of 48 glomus tumours of the hand, which have been reviewed with an average follow-up of 4.5 years (2-14). The tumour was nearly always sited in the distal digit, para-ungual (22 cases), more rarely subungual or under the pulp, with an even distribution among the fingers. Diagnosis was made preoperatively in 37 of 47 tumours of the digits, based on clinical features: consistent eliciting of pain by touch, less often by chill and occasionally accompanied by vasomotor phenomena. The pain and therefore the tumour could be accurately located with the tip of a pencil (Love's sign); these symptoms are abolished by inflation of a tourniquet proximally (Hildreth's sign). In 40% of cases a small defect in the distal phalanx is visible on plain radiographs, as well as an enlargement of the subungual tissues when the tumour is dorsal. The surgical approach was usually para ungual, in a sub-periosteal plane. Tumours were small (3.3 mm) and rarely multiple (3 cases). In 46 cases the pain was relieved quickly and definitively. Two true recurrences occurred after 5 years, without a satisfactory explanation. Except for those cases with transungual approach, there was no aesthetic compromise. We maintain that careful clinical assessment provides the diagnosis in most cases. Plain radiographs, lateral and comparative, are useful. MRI scan may occasionally prove of diagnostic value. The lateral ungual approach permits complete excision and healing. Recurrence is rare.

[Carpal tunnel syndrome in hemodialysed patients. Analysis of 110 surgically-treated cases]. / Syndrome du canal carpien chez l'hémodialysé. Analyse de 110 cas opérés.

The retrospective study of this homogeneous series of 110 carpal tunnel syndromes in 70 patients on hemodialysis shows the usual severity of symptoms (right thenar amyotrophy in 56% of cases, advanced nerve lesions in 66%). Synovitis plays a major role, as demonstrated by the frequency of clicking fingers (45%), and requires synovectomy that allows thoroughly exploring the carpal tunnel and removing a highly aggressive element against tendons. In this study, fisculae do not seem to have the generally admitted importance, but it requires surgical caution. Two thirds of patients were followed up for an average of 3 years. Apart from 3 recurrences, the control of pain is good but sensorimotor recovery is long and often incomplete, which is in favor of earlier surgery.