[Isolated febrile intra-alveolar hemorrhage detected in leptospirosis]. / Hémorragie intra-alvéolaire fébrile isolée révélant une leptospirose.

We report observation of a patient of 25 years who presented with an isolated intra-alveolar haemorrhage occurring during the course of an illness suggestive of septicaemia. Considering the epidemiological context of inhalation of water from the River Saone, the diagnosis of acute leptospirosis ictero-haemorrhagica was considered and was confirmed by serological tests. Several publications draw attention to the pulmonary manifestations of acute leptospirosis which remains rare and poorly understood. Pulmonary disease is characterised not by an infectious alveolitis but by the occurrence of intra-alveolar haemorrhage whose pathogenetic mechanism remains under discussion.

[Acute pleurisy secondary to ovarian hyperstimulation after in vitro fertilization]. / Pleurésie aiguë secondaire à une hyperstimulation ovarienne après fécondation in vitro.

Pleurisies due to the syndrome of ovarian hyperstimulation typically accompany ascites and in their most severe form are associated with haemoconcentration, hypovolaemia and thromboembolic phenomena. It is not unusual in this context for pleural effusions to be isolated. They may occur during treatment for sterility by inducing ovulation, they are exudates and predominantly right sided. The pathophysiology is not clear and results in vascular hyperpermeability. Currently, no treatment aimed at the aetiology has proven its own efficacy. Spontaneous regression of the effusion is the rule but in severe forms, where the prognosis is uncertain, correction of hypovolaemia is a priority.