[Bilateral pleural thickening pseudo-tumour due to tuberculosis]. / Epaississements pleuraux pseudotumoraux bilatéraux d'origine tuberculeuse.

The authors report the case of a 20 year old Senegalese woman in whom pulmonary and bone tuberculosis presented as bilateral, lobulated pleural thickening without effusion, associated with a vertebral abscess at D 9-10. The diagnosis was obtained by histological examination of a CT guided pleural biopsy. After 12 months treatment there was complete resolution of the pleural disease. Tuberculous pleural disease is rarely bilateral and such presentation as a pseudo-tumour is very rare in Europe. Anatomically the pleural disease would seem to have been secondary to the vertebral disease as the result of direct spread.

[Endobronchial localization of Launois Bensaude syndrome]. / Localisation endobronchique d'un syndrome de Launois-Bensaude.

Launois Bensaude syndrome is a benign, asymetric lipomatosis involving the upper back, shoulders, neck and arms. The disorder is usually asymptomatic although mediastinal lipomas, extrinsic compression of trachea, obstructive sleep apnea syndrome have been described. We report for the first time to our knowledge a case of Launois Bensaude syndrome with bronchial submucosal adiposis infiltration presenting as flask, smooth, begnin tumor like formation involving several bronchi. Whether this submucosal adipose infiltration participate to the obstructive syndrome is discussed.

[Radiological evidence of lung involvement in metal fume fever]. / Atteinte pulmonaire radiologique au cours d'une fièvre des métaux.

We report the case of a 32-year-old welder who developed a flu-like syndrome a few hours after founding zinc. The patient experienced fever, headache, muscle pain and dyspnea that resolved spontaneously with a few hours. The diagnosis of metal fume fever was retained. The chest x-ray evidenced bilateral diffuse infiltrative pulmonary lesions, rarely described in this syndrome. Metal fume fever is a likely diagnosis in exposed patients who develop fever with diffuse lung involvement.

[Respiratory manifestation of Crohn's disease. Apropos of a case in an adolescent]. / Manifestations respiratoires de la maladie de Crohn. A propos d'un cas chez un adolescent.

The authors report an original case of Crohn's disease in a teenager with breathlessness and alveolar lymphocytosis. This respiratory involvement is uncommon in pediatric. About the literature, the authors review the significant and the prognostic value of alveolitis in Crohn's disease.

[Clinical and bacteriological evaluation of sisomicin in sixteen cases of severe bronchopulmonary infection (author's transl)]. / Evaluation clinique et bactériologique de la sisomicine dans seize cas d'infections broncho-pulmonaires sévères.

Sisomicin, an aminoglycoside antibiotic, was used as sole bactericidal therapy in sixteen cases of severe bronchopulmonary infection for an average of 11,5 days (range 7 to 14) with a dose of 3,5 mg/kg per day in three intramuscular injections. Fifteen of these hospitalized patients presented with chronic airway obstruction which resulted in lowered O2 saturation (SaO2 congruent to 86,1%, range 74 to 93) and, in twelve patients, hypercapnia (PaCO2 = 55,7 torr, range 33--73). Two of these patients were under continuous assisted ventilation. Two patients had a lower lobe infiltrate and a lung abscess respectively. Proteus (n = 3), Pseudomonas (n = 9), K. pneumoniae (n = 2), E. Coli (n = 1), Enterobacter (n = 1), S. aureus (n = 1) and D. pneumoniae (n = 1) were the dominant organisms in the bronchial secretions isolated by Mulder's method; P. aeruginosa was associated with K. pneumoniae, P. rettgeri and E. coli respectively in three cases. In thirteen cases, either a clinical cure (n = 2) or a definite improvement was observed (sputum volume and purulence, auscultatory signs, temperature). However, among these patients were three cases of superinfection/colonization and two cases of persistent organisms. In addition, in two of the three cases showing no improvement colonization occured. The favorable results of this study appear to be due to vigorous antibiotic therapy combined with intensive adjunct therapy. No adverse local or systemic reactions clearly attributable to the drug were observed.

[Immediate effects and conditions of effectiveness of a session of mechanical assisted ventilation (M.A.V.) in severe respiratory insufficiency (PaCO2 greater than 50 mmHg) out of intensive care conditions (author's transl)]. / Effets immédiats et conditions d'efficacité d'une séance d'assistance ventilatoire (V.A.) chez les I.R.C. graves (PaCO2 greater than 50 mmHg) en dehors de toute réanimation.

Effectiveness and haemodynamic tolerance of M.A.V. in conscious patients with a severe respiratory insufficiency is mainly due to the proper adaptation to ventilator with low frequency and adequate V.T. Thus M.A.V. is an eventual complement to directed ventilation exercises which in addition reduce the "rebound" of hypoxia and hypercapnia after a M.A.V. session. A proper adaptation ensures haemodynamic tolerance. Expiratory time should be sufficient in such obstructive patients. A post inspiratory pause can improve V.C.O2. Nevertheless, it should not shorten inspiratory time to less than one second and for each patient the best ventilatory profile should be properly established taking into account blood gases, circulatory, expired CO2 and clinical monitoring.

[Anatomic and bacteriological study of surgically extracted valves in patients with bacterial endocarditis]. / Etude anatomique et bactériologique des pièces de valvulectomie chez les malades ayant une endocardite bactérienne

We studied 64 cases of bacterial endocarditis which required heart surgery for hemodynamic defects and/or failure of the antibiotic therapy. We performed a bacteriologic and histologic investigation of the removed valves. The organisms were evidenced through culture and specific stainings. According to the different organisms we evaluated the best duration of antibiotic therapy to achieved sterilization, and suggest a helpful medical and surgical treatment for the bacterial endocarditis.