Agrobacterium radiobacter bacteremia in oncologic and geriatric patients: presentation of two cases and review of the literature.

INTRODUCTION: We report here two cases of Agrobacterium radiobacter bacteremia. These cases were observed at the same institution over a short time period (3 months). CASE REPORTS: The first patient was a female cancer patient receiving third-line chemotherapy for ovarian carcinoma. When she developed bacteremia, she was neutropenic and had an indwelling catheter that was removed as part of the treatment. The second case was a geriatric patient admitted from home with bacteremia, clinical signs of septic shock, and concomitant acute cholecystitis. OUTCOME: Both patients responded promptly and completely to antibiotherapy. No recurrence was observed.

[First report of coccidioidomycosis associated with Sweet syndrome]. / Première association d'une coccidioïdomycose et d'un syndrome de sweet.

BACKGROUND: We describe the first reported case associating coccidioidomycosis and Sweet syndrome, two uncommon diseases in Europe. CASE REPORT: One month after traveling to Mexico, a 47-year-old woman developed a maculo-papulous rash on her trunk, neck and limbs. She also had cough, associated with signs of an upper respiratory tract infection and weight loss. Sweetís syndrome was first diagnosis and confirmed histologically on a skin lesion biopsy. An aspectific pulmonary infiltrate, associated with a left-sided paracardiac opacity was found on chest X-rays and the CT scan. Bronchoalveolar lavage products contained more than 60% lymphocytes. Serology using coccidioidin showed an F-precipitin on agar (IgM) and an IgG-titre of 1:8, leading to the diagnosis of primary Coccidioides immitis infection with a probable lung localization. DISCUSSION: Search for an associated disease should be made in patients with Sweet syndrome. The Sweet syndrome coccidioidomycosis association could be related to TH-1 lymphocyte proliferation.

[Intrathoracic splenosis. Apropos of a case]. / Splénose intrathoracique. A propos d'un cas.

The authors report an exceptional case of intrathoracic splenosis in a 34 year old woman suffering from a circulation injury with rupture of the spleen and left diaphragm and hemothorax. She had been splenectomized. Eleven years later, a systematic thoracic X-ray examination revealed a rounded opacity of the left extremity. Exeresis of a lump the size of a nut located in the pleural space without individualized vascular pedicle was performed. The lesion showed macroscopic and microscopic characteristics of splenic tissue. If peritoneal splenosis is more frequent, intrathoracic splenosis is exceptional (only 7 observations known). Every time, a traumatic splenic antecedent has been noted. The etiopathogeny consists of an autograft of splenic tissue most often in the pleural cavity, when a diaphragmatic lesion has been associated to the injury. The lesion is asymptomatic and does not provoke complication in that area. Histologically, the splenic parenchyma can be normal or limited to the red pulp with a more or less important degree of white pulp. The histological differences with the normal or accessory spleen are the non contractile collagenous texture of the capsular and the septa and the absence of hila. One should consider this etiology when antecedents of splenic and diaphragmatic traumatism are noted. Hepato-splenic scintigraphy can be useful in the diagnosis and help to avoid thoracotomy.