[Dyspnea of effort associated with a congenital aortic malformation]. / Une dyspnée d'exercice associée à une malformation aortique congénitale.

INTRODUCTION: We report the case of a young woman presenting with dyspnoea of effort. Her records noted that correction of a double aortic arch had been performed in the neonatal period. At rest her flow/volume loop showed a moderate reduction of peak flow without an expiratory plateau. Exercise capacity was limited by sudden onset, during the last 2 stages of the test, of inspiratory dyspnea and tachypnea. During recovery there was no evidence of bronchospasm. CASE REPORT: With this picture we suspected upper airway obstruction and bronchoscopy revealed tracheal compression to 50% of normal. CT scan with 3 dimensional reconstruction showed the trachea compressed between 2 aortic branches. In order to confirm that the tracheal compression increased during exercise we induced sympathetic stimulation by a "handgrip" test that reproduced the inspiratory dyspnea and lead to a reduction in inspiratory flows. CONCLUSION: We have thus demonstrated that the increase in tracheal compression leading to limitation of airflow on exercise was due to an increase in aortic pressure and not to an increase in ventilatory flows.

[Lemierre syndrome: clinical and radiological characteristics of a rare disease]. / Syndrome de Lemierre: caractéristiques cliniques et radiologiques d'un diagnostic rare.

A benign oropharyngial infection without appropriate treatment can be complicated by a jugular vein thrombosis and disseminated septic embolies with deleterious pulmonary effects. This septic clinical picture most commonly known as Lemierre syndrome is attributed to Fusobacterium necrophorum, a Gram negative anaerobic bacilli. We describe a case of a young patient who has presented this syndrome accompanied by typical pulmonary manifestations. Adequate antibiotic treatment for 3 weeks associated with anticoagulant treatment for about 3 months duration have allowed a complete recovery without sequel.

[Spontaneous chylothorax. Apropos of a further case]. / Chylothorax spontané. A propos d'une nouvelle observation.

The authors describe a case of spontaneous chylothorax occurring in a 50-year-old woman after stretching exercises of the upper limbs. A positive diagnosis was made based on pleural aspirate and a biochemical study of the pleural liquid (triglycerides > 3 gm/l). The chylothorax is said to be spontaneous when detailed investigations are negative. The outcome was satisfactory with complete regression of the symptoms after pleural aspirate and a low diet in long chain triglycerides but the authors recall that treatment may be surgical in cases of multiple recurrence.