[False hyperchloremia in a bromide intoxication]. / Fausse hyperchlorémie révélant une intoxication aux bromures.

A false hyperchloremia in a patient with a history of depression suspected bromide intoxication. The diagnosis was confirmed by an increased bromide concentration > 20 mmoL.L-1. Rehydration was effective and allowed to decrease bromide concentration. In conclusion, hyperchloremia associated with a negative anion gap is a clue to the diagnosis.

[Spontaneous idiopathic chylothorax. Case report and review of the literature]. / Chylothorax spontané idiopathique. Revue de la littèrature á propos d'un cas.

We present a new case of bilateral spontaneous idiopathic pneumothorax, occurring in a 52-year-old woman. A literature review of similar cases shows a quite reproducible picture, consisting in the occurrence of supraclavicular swelling and left or bilateral chylothorax after a mild effort in a woman in her fifties.

[Severe acute asthma in the emergency room: amelioration of decreased peak flow rate is interpreted with difficulty]. / Asthme aigu grave aux urgences: l'amélioration du débit de pointe doit être interprété avec discernement.

We report a severe acute asthma case whose course was marked by persistent hypoxemia whereas proximal flows were normalized. This discordance reveals a ventilation/perfusion mismatch. This data suggests that care must be taken in interpreting the peak flow improvement during acute severe asthma management.

[Bacteremia and Pasteurella multocida pneumonia revealing HIV infection]. / Bactériémie et pneumopathie à Pasteurella multocida révélant une infection à VIH.

Pasteurella multocida is a major pathogen in local wound infections due to animal bites. Pneumonia and bacteremia are less frequent and usually associated with local or general impairment of host defenses. Scarce reports exist about Pasteurella multocida infections in HIV infected patients. We report here a case of hypoxemic pneumonia and bacteremia due to Pasteurella multocida revealing an HIV infection in a young man.

[Pulmonary calcinosis]. / Calcinose pulmonaire.

Interstitial pulmonary calcinosis was discovered after finding hypercalcaemia in a man of 56 who had been treated for several months with Hydrochlorthiazide. This was a secondary hyperparathyroidism due to the formation of parathyroid adenomatous cysts. This illness had been quiescent until then and was probably revealed as a result of the hydrochlorthiazide therapy.

[Hepatic granulomatosis and positive serodiagnosis of Yersinia infections]. / Granulomatoses hépatiques et séro-diagnostics de yersiniose positifs.

Four cases of hepatic granulomatosis with positive Yersinia serologic tests are reported. In one case, the Wright serodiagnostic tests were also positive. In the three other cases, no other likely etiology was demonstrated. The authors recall the main causes of hepatic granulomatosis, diagnostic criteria of Yersiniosis infections, and the possible occurrence of simultaneous positive serodiagnostic tests for Yersinia enterocolitica type 9 and Brucella abortus.

[Hepatopathies associated with chronic carriage of HBs antigen in black African immigrants in France]. / Les hépatopathies associées au portage chronique de l'antigène hbs chez les noirs africains immigrés en France.

The authors report two studies : 1) Retrospective : study of liver biopsies in 44 Africans : 22 were HBs Ag positive and 22 HBs Ag negative ; 10 of the HBs Ag positive subjects were found to have chronic persistent hepatitis (CPH), 4 chronic active hepatitis (CAH) and 3 cirrhosis ; 2 of the HBs Ag negative subjects were found to have CPH and 3 CAH ; as far a biological findings are concerned, only the CAH and cirrhosis groups differed from the control group, with higher prothrombin times, transaminase levels and gammaglobulin levels. 2) Prospective : study of the incidence of HBs Ag carriage in 168 Africans ; 17.8 % of them were found to be carriers ; no correlation was found between HBs Ag carriage and S. haematobium schistosomiasis or hemoglobinopathies.

[Gram-negative septicemia and bacteremia in an internal medicine department]. / Septicémies ou bactériémies à gram négatif dans un service de médecine interne.

Among 31 patients with positive blood cultures for gram-negative bacilli seen in a department of internal medicine, 13 had at least 3 positive blood cultures from samples taken over more than 12 hours and were diagnosed as having septicemia (group I) ; 18 patients had less than three positive blood cultures over the same period or had several positive blood cultures over a shorter period and were diagnosed as having bacteremia (group II). There were no significant differences between these two groups concerning age, sex, fever, other clinical features, or biological findings. E. coli was recovered in 70 % of cases and was almost always related to urinary infection. 8 patients died (3 in group I, 5 in group II), 6 of whom had cirrhosis. The sensitivity of the pathogens to the main antibiotics is described. The most often used antibiotic combination was ampicillin-gentamycin. It is suggested that in departments receiving patients from outside the hospital rather than from intensive care units the ampicillin-gentamycin combination can be advocated as the first treatment. As there were no significant differences between patients with septicemia or bacteremia, in severe infections a single positive blood culture should be taken into account and discrimination between septicemia and bacteremia is useless.

[Angiocholitis and polymicrobial septicemia caused by food obstruction in a patient with a biliodigestive anastomosis]. / Angiocholite et septicémie polymicrobienne par obstacle alimentaire dans une anastomose bilio-digestive.

A case of angiocholitis with polymicrobic septicemia in an 85-year-old man with a history of cholecystectomy and choledocho-duodenal anastomosis is reported. The biliary tract was obstructed by a piece of tomato skin. Antibiotherapy and fibroscopic extraction of the skin ensured recovery. The authors recall the low incidence of polymicrobic septicemias, diagnostic criteria, promoting factors, poor prognosis, and the responsibility of digestive reflux and above all of stasis and high pressure in angiocholitis and septicemia following biliodigestive anastomosis.

[Critical study of serodiagnosis of Yersinia infections]. / Etude critique du sérodiagnostic des yersinioses.

The study concerns 100 patients who are divided in two dissimilar groups. The first group is composed of 39 patients who have signs of possible Yersiniosis infection. In second group composed of 61 cirrhotics patients, the serodiagnosis was systematic. The rate of positive serology, comparing with healthy patients, is significantly high in both groups: 61,5 p. 100 (first group) 64 p. 100 (second group). Six cases in the first group were very likely caused by Yersinia infection and confirm the utility of the serodiagnosis in front of evocative symptomatology. But many positive serodiagnosis remain unexplained and the greatest care must be taken in appreciation of these results. Among cirrhotic patients, the positive serology is not correlated with evocative symptoms and would be the result of asymptomatic bacteriemias.

[Hepatic tuberculosis: anatomical and clinical findings. A review of forty-six cases (author's transl)]. / Tuberculose hépatique. Aspects anatomo-cliniques à propos de quarante-six cas.

Over eight years the authors recorded 46 cases of hepatic tuberculosis. Most cases occurred in patients from black Africa. Forty-five patients had at least one extrahepatic tuberculous localization. Moderate cholestasis, without jaundice, found in 75% of patients, was the main biologic disorder. Upon histologic examination, five different types of granulomas were found. Each one has a specific predictive value concerning the outcome of the tuberculous infection.