[Acute psychotic access following the administration of isoniazid]. / L'accès psychotique aigu secondaire à la prise d'isoniazide.

INTRODUCTION: Acute psychotic access is defined as the occurrence of a single, acute, and intense psychotic episode in a subject without a neurological or psychiatric history. Isoniazid (INH), a major antibacillar, is the drug most often involved in the occurrence of this psychiatric disorder. However, this side effect is rare and only a few cases have been reported in the literature. CASE REPORT: A 57-year-old female patient with diabetes mellitus presented miliary tuberculosis for which an antibacillar treatment was prescribed. Three days later, she presented an acute psychotic access requiring the withdrawal of the INH and the prescription of neuroleptic drugs, without any pyridoxine supplementation. The lab tests were normal. The good clinical evolution after the INH withdrawal confirmed its imputabilty. CONCLUSION: Acute psychotic access is a severe and exceptional complication following the administration of INH. Emergency treatment is the only guarantee of a good outcome.

[Pneumocystis jirovecii: what does this mean?]. / Pneumocystis jirovecii: ce nom, que signifie-t-il?

Pneumocystis was discovered nearly a century ago. It causes fatal pneumonia in immunocompromised individuals, especially in AIDS patients. Knowledge of the different species remained rudimentary until the mid-eighties when DNA analysis revealed its extensive diversity. In fact, it is no longer considered as a zoonosis. Pneumocystis organisms derived from different hosts have very different DNA sequences, indicating multiple species. Due to the genetic and functional disparities, the organism that causes human PCP is now named Pneumocystis jirovecii/Frenkel, 1999. We continue to call Pneumocystis carinii the species found in rats. This will allow for a single international language and avoid confusion. Changing the organism's name does not preclude the use of the well-known acronym PCP because it can also be read "PneumoCystis Pneumonia." The DNA sequences and genotypage have shown that variations exist among samples of P. jiroveci. Molecular biology is helpful in the study of the mechanisms of transmission, which can only occur in the same host and the different resistances as well as providing a better understanding of the relationship between host and pathogen. P. jirovecii pneumonia in immunosuppressed patients was previously thought to result from the reactivation of a latent infection acquired in early childhood. However, today, it is believed to result from a new infection from an exogenous source.

A laryngocele revealing a small cell lung carcinoma.

BACKGROUND: Laryngocele is defined as an abnormal dilatation of the laryngeal ventricle. It is a very rare entity, and the exact underlying mechanism is still unclear. Laryngoceles are associated with larynx carcinoma but not yet lung cancer. CASE PRESENTATION: A 46-year-old man presented with stridor, wheezing, dyspnea at rest, hoarseness evolving over two months, and cyanosis secondary to cervical swelling. His medical history included a 72 pack-year smoking habit and chronic obstructive pulmonary disease for 10 years. Airway management included a surgical tracheotomy for respiratory distress. A neck CT revealed laryngocele. A chest X-ray showed a left basal pulmonary opacity. Bronchoscopic exploration found an infiltrated and narrow left stem bronchus with complete stenosis of the lingula. Pathology revealed a small cell lung carcinoma. CONCLUSION: Our case shows the possible association of laryngocele and lung carcinoma. The pathophysiology was explained by the long history of tobacco smoking and the underlying chronic obstructive pulmonary disease with chronic cough.