[Pseudotumoral calcinosis of the wrist compressing the radial nerve in systemic sclerosis]. / Compression du nerf radial au poignet par une calcinose pseudo-tumorale au cours d'une sclérodermie systémique.

BACKGROUND: Pseudotumoral calcinosis, a rare complication of systemic scleroderma, is characterized by the presence in extra-articular tissue, but rarely intra-articular tissue, of large masses made up of hydroxyapatite crystals. PATIENTS AND METHODS: We report an original case of intra- and extra-articular pseudotumoral calcinosis of the wrist diagnosed in a patient followed for mild systemic scleroderma. The calcinosis was revealed in a highly unusual way via ductal syndrome secondary to compression of the radial nerve in the wrist. Surgical treatment resulted in marked clinical and functional improvement. COMMENT: Although subcutaneous calcinoses are a fairly common complication of systemic scleroderma, the pseudo-tumoral form remains extremely rare. It may be complicated by pain, recurrent infection, and functional restriction, but literature contains only very rare reports of its revelation via ductal syndrome.

[A rare infectious etiology of COPD exacerbation]. / Une étiologie infectieuse rare d'exacerbation de bronchopneumopathie chronique obstructive.

Chronic obstructive pulmonary disease (COPD) is a common respiratory disorder. Its exacerbation is infectious in more than half of the cases: with viral priority, while parasitic causes remain exceptional. In this work, we report a case of a COPD exacerbation caused by a visceral leishmaniasis (VL) complicated by a macrophage activation syndrome in an adult living in a Moroccan non-endemic region for this of leismaniasis form. In such atypical clinical feature, the diagnosis of VL was based on the myelogram after presence of peripheral cytopenia. Despite the seriousness of these pathologies, the early and specific treatment of VL allows a quickly improvement in the disorders caused by these diseases.

[Thrombo-haemorrhagic disease-related hypoprothrombinemia-lupus anticoagulant syndrome revealing a light chains multiple myeloma]. / Un tableau thrombo-hémorragique en rapport avec un syndrome hypoprothrombinémie ­ anticoagulant lupique révélant un myélome multiple à chaînes légères.

Thrombosis and hemorrhage are two opposing manifestations of multiple myeloma. These hemostatic disorders are present in less than 12% of patients at diagnosis and involve various pathophysiological mechanisms. We report the case of a 39-year-old patient with multiple myeloma revealed by the association of a hemorrhagic syndrome and deep vein thrombosis related to a hypoprothrombinemia-anticoagulant lupus syndrome.

[Pyoderma gangrenosum following hematopoietic stem cell transplantation]. / Pyoderma gangrenosum après allogreffe de cellules souches hématopoïétiques.

BACKGROUND: Pyoderma gangrenosum (PG) is a rare form of neutrophilic dermatosis and is a potential complication in a number of systemic diseases. These include blood diseases, which represent 3.5% of cases, with the main forms being monoclonal gammopathy and acute myeloid leukemia. PATIENTS AND METHODS: Herein we report a case of pyoderma gangrenosum in a female patient who had undergone haematopoietic stem cell allograft six months earlier as part of her treatment for acute T-cell leukemia. DISCUSSION: This condition forms one of the general disorders potentially associated with PG and is a dermatological disorder that can occur in marrow graft patients.

[Soft palate chronic lymphocytic leukemia]. / Leucémie lymphoïde chronique vélaire.

INTRODUCTION: Forty percent of non-Hodgkin lymphoma (NHL) are located in extranodal sites. The palatal location of chronic lymphocytic leukemia (CLL) is usually observed at a late stage of the disease. CASE: We report the case of a 62-year-old male patient managed for 8 years for CLL, having presented with a soft palatal tumor in the last 2 years. The diagnosis of CLL was made by immunohistochemistry. The patient was given 6 courses of chemotherapy combining fludarabine, cyclophosphamide, and rituximab. DISCUSSION: The diagnosis of CLL requires immunohistochemistry. Chemotherapy is the first line treatment. The complication may be an aggressive lymphoma (Richter).

[Sarcoïdose in patient with chronic hepatitis C treated with pegylated interferon]. / Sarcoïdose chez un patient traité par interféron pégylé pour une hépatite chronique C.

Induced sarcoïdosis during therapy with interferon for chronic viral hepatitis C involves mainly by isolated cutaneous lesions or with lung lesions. Systemic forms are very rare. We report an observation. A 50-year-old patient developed a systemic sarcoïdosis two months after the end of treatment for hepatitis C with pegylated interferon and ribavirin with lung, joint and hepatic manifestations. After starting corticosteroid therapy, the evolution was favourable. Induced sarcoïdosis by interferon therapy is rare, treatment necessitates stopping interferon, and sometimes corticosteroid therapy.

[The acute respiratory distress syndrome in malaria: is it always the prerogative of Plasmodium falciparum?]. / Le syndrome de détresse respiratoire aiguë au cours du paludisme: est-il toujours l'apanage du Plasmodium falciparum?

Severe malaria causes nearly one million deaths annually in endemic areas and is a public health priority worldwide. Severity associated with the occurrence of acute respiratory distress syndrome (ARDS) is a well-known complication of infection with Plasmodium falciparum and can reach 25% of infected adults. However, ARDS is less often described with other Plasmodium species. We report the case of a young Moroccan soldier who died in an array of ARDS related to malaria of Plasmodium ovale 7 months after his return from an endemic country.

[Acute renal failure following internal administration of povidone iodine: a case report]. / Insuffisance rénale aiguë secondaire à la povidone iodée: à propos d'un cas clinique.

INTRODUCTION: Using iodine povidone in internal way may be responsible of severe adverse effects, sometimes causing death of the patients. EXEGESE: A 36th years old woman, with a secondary sterility has benefitted of an uterine opacification by iodine povidone before a laparotomy and a salpingotomy. In post surgery she presented an anuric acute renal failure and a severe anaemia which have needed a transfusion. Outcome was favourable with a recuperation of diuresis and a full normalization of the renal function. CONCLUSION: The authors recommend to respect the indications of iodine povidone.

[Septicaemia due to Lactobacillus jensenii: bacteriological diagnostic orientation]. / Septicémie à Lactobacillus jensenii: orientation diagnostique bactériologique.

Septicaemia concerning Lactobacillus jensenii is exceptional. This bacteria commensal of the normal human flora is known for its low pathogenicity. We report here the observation of a woman, 50 years old, who was admitted in our service for an obstructive acute renal failure and who has presented a septicaemia due to L. jensenii, with a favourable issue by use of antibiotics (amoxicillin-clavulanic acid). This observation permits to report the clinical and bacteriological characteristics of L. jensenii. The importance of the immunodepressed status (diabetes mellitus, chronic renal failure) and use of the endoureteral acts is mentioned.

[Severe imported malaria. The experience of the military hospital of Marrakech]. / Le paludisme grave d'importation à propos de neuf cas: expérience de l'hôpital militaire Avicenne de Marrakech.

Incidence of severe imported malaria increases with the multiplication of humanitarian and military missions in malarial endemic areas. The purpose of this study was to describe the demographic, clinical, therapeutic and outcome aspects of 9 cases which have been hospitalized in the intensive care unit and medecine service of the military hospital of Marrakech, between january 2001 and december 2004. Out of 68 patients admitted with symptomatic malaria during this period, 9 cases were considered as severe. All of them were male soldiers (mean age: 33,3 years), 7 of them have stayed in Democratic Republic of Congo, and 2 in Ivory Coast. Chemoprophylaxis consisted in chloroquine plus proguanil in 5 cases and mefloquine in 4 cases. The mean duration of stay in endemic area was 9,3 months. The clinical presentation was dominated by troubles of consciousness, which justified initial admission in the intensive care unit. The mean duration of hospitalization was 3,3 days in intensive care unit and 5,6 days in the medical department. Thick smear always revealed high parasitemia (5-15%) with Plasmodium falciparum, associated with Plasmodium ovale in two cases. Antimalarial treatment consisted in quinine salts administration. Evolution was favourable without recurrence in 7 cases, but 2 deaths were recorded. Severe imported malaria remains associated with bad outcome and requires early diagnosis and close monitoring of such cases.

[Severe imported malaria: the experience of the Avicenna military hospital of Marrakech]. / Le paludisme grave d'importation à propos de neuf cas : expérience de l'hôpital militaire Avicenne de Marrakech.

Incidence of severe imported malaria increases with the multiplication of humanitarian and military missions in malarial endemic areas. The purpose of this study was to describe the demographic, clinical, therapeutic and outcome aspects of 9 cases which have been hospitalized in the intensive care unit and medecine service of the military hospital of Marrakech, between january 2001 and december 2004. Out of 68 patients admitted with symptomatic malaria during this period, 9 cases were considered as severe. All of them were male soldiers (mean age: 33,3 years), 7 of them have stayed in Democratic Republic of Congo, and 2 in Ivory Coast. Chemoprophylaxis consisted in chloroquine plus proguanil in 5 cases and mefloquine in 4 cases. The mean duration of stay in endemic area was 9,3 months. The clinical presentation was dominated by troubles of consciousness, which justified initial admission in the intensive care unit. The mean duration of hospitalization was 3,3 days in intensive care unit and 5,6 days in the medical department. Thick smear always revealed high parasitemia (5-15%) with Plasmodium falciparum, associated with Plasmodium ovale in two cases. Antimalarial treatment consisted in quinine salts administration. Evolution was favourable without recurrence in 7 cases, but 2 deaths were recorded. Severe imported malaria remains associated with bad outcome and requires early diagnosis and close monitoring of such cases.