Severe Neuroexcitatory Reaction: A Rare and Underrecognized Life-Threatening Complication of Propofol-Induced Anesthesia.

We describe a case of severe neuroexcitatory reaction with hyperthermia after administration of propofol in a 43-year-old patient suspected of a relapse of sarcoidosis who underwent bronchoscopy. This resulted in a lengthy stay in intensive care and long-term neuropsychological impairment. A review of the literature shows that severe neuroexcitatory symptoms (seizure-like phenomena, abnormal hypertonic, and/or jerky movements) occur rarely after propofol administration and may be life-threatening. Due to the paucity of data, the treatment is mostly empirical. The diagnosis can also be delayed owing to underrecognition. We conclude that health practitioners who frequently use propofol should be aware of this specific manifestation of drug toxicity, which albeit rare can be devastating for the patient.

[Salmonella aortitis in an elderly patient†: clinical case and review of the literature]. / Aortite à salmonelle chez un patient âgé†: cas clinique et revue de la littérature.

Gastroenteritis due to non-typhoidal Salmonella (NTS) is usually considered as a benign infection. NTS can nevertheless cause severe diseases with high mortality. Invasive NTS infections may present as bacteremia without other manifestations, particularly in immunocompromised hosts. They may also correspond to extra-digestive infections in various body sites. Patients with cardiovascular diseases are at risk for endovascular infections, aortitis being the most frequent. These infections are difficult to diagnose and require surgery.

La gastroentérite à salmonelle non typhoïde est une maladie généralement considérée comme inoffensive. Pourtant, chez certains hôtes, cette bactérie peut se montrer particulièrement virulente et mener à des complications avec une mortalité élevée. Nous décrivons un cas d'aortite à Salmonella enteritidis chez un patient âgé avec un profil athérosclérotique. La salmonellose invasive peut prendre la forme d'une bactériémie isolée, surtout chez les patients immunosupprimés. Dans d'autres cas, elle se manifeste par des foyers extradigestifs de localisations diverses. Les infections endovasculaires, dont l'aortite est la plus fréquente, atteignent les patients à haut risque cardiovasculaire ; elles sont difficiles à diagnostiquer et nécessitent une prise en charge médico-chirurgicale.