[Thymoma and disseminated lupus erythematosus. Two new cases and review of the literature]. / Thymome et lupus érythémateux disséminé. A propos de deux nouvelles observations et revue de la littérature.

INTRODUCTION: Thymoma is a tumour originating in the epithelial cells of the thymus, associated with several immunologic disorders. The association of thymoma with systemic lupus erythematosus has rarely been described. We report two cases of this association. EXEGESIS: Description of two cases and a review of the literature. Mr T. was 41 years old when the diagnosis of thymoma and lupus was made. The thymectomy did not influence the evolution of his lupus. Mrs G. had been treated because of a lupus for 8 years prior to developing a thymoma. One year later she presented with erythroblastopenia, which was only sensitive to cyclosporin. CONCLUSION: The association between lupus and thymoma has been reported in 36 cases in the literature. Thymoma is benign in 59% of the cases. The clinical presentation of lupus is nonspecific except for age, median 48 years, and sex ratio, 4:3. The clinical outcome of the lupus is not influenced by the thymectomy. Thymoma may precede lupus with a delay of several years or it may be diagnosed concurrently or several years later. This association is not accidental, though the pathogenic link between these conditions remains unknown. One could suppose that the decrease of the thymic function in the course of thymoma could enhance the expression of autoreactive T lymphocytes as well as the activation of B cells. Patients should be followed after thymectomy because autoimmune diseases, particularly lupus, may develop belatedly. On the other hand, thymoma may be suspected mainly when lupus occurs in patients around 50 years of age.

Q fever meningoencephalitis in five patients.

Within the last four years, we have observed five patients with epidemiological, clinical, and serological features that were consistent with Q fever meningoencephalitis. Attempts to isolate Coxiella burnetii from the cerebrospinal fluid of two patients were unsuccessful. Neurological features ranged from coma, general seizures, confusion, to palsy and meningitis. All patients were febrile. These patients were neuroradiologicaly investigated. Since 1984, four other cases have been reported in the literature. Antibiotics with good penetration into the cerebrospinal fluid, such as new quinolones, may be useful for treatment of confirmed cases. Q fever should be considered as a possible etiology of meningitis in endemic areas, and diagnosis should be confirmed by serology.

[Treatment of typhoid fever with cefoperazone]. / Traitement de la fièvre typhoïde par la céfopérazone.

Cefoperazone was given parenterally to 10 patients (9 woman and 1 man, aged 19 to 75 years) with positive blood cultures for Salmonella typhi (9 cases) or Salmonella paratyphi A (1 case). Daily dosage was 0.5 g on the first day, 1 g on the second and 2 g on the third. Five patients had 4 g on the fourth day. Average time to defervescence was five days. There were no relapses. Cefoperazone is therefore satisfactory for treating typhoid fever, especially caused by ampicillin- or chloramphenicol-resistant bacteria.

[Campylobacter fetus fetus bacteremia. Review of the literature apropos of 2 cases]. / Bactériémie à Campylobacter foetus foetus. Revue de la littérature à propos de deux cas.

The authors report two cases of bacteremia due to Campylobacter fetus fetus (also called C. fetus intestinalis). One was a 22-year-old female, under treatment for active systemic lupus erythematosus, who died. The other was a fifty-year-old male, in a poor general condition, who had a self-limited acute febrile dysentery. In this patient, C. fetus fetus was found in stools after apparent recovery, raising the problem of healthy carriers. A review of the literature shows 64 other such cases.

[Hydatic cyst of the pelvis. Failure of treatment with flubendazole]. / Kyste hydatique du bassin. Echec du traitement par flubendazole.

In a 54 year old, algerian male we found a inoperable hydatid disease of the pelvis. A treatment by flubendazole 4 g/day is started on February 1982. The patient presents a neck of the femur fracture, on April 1982; on September 1982 he had a myocardial infarctus and a second one in February 1983. On March 1983 he had a new femur fracture. The biological data show no difference in hypereosinophilia and serological exploration. In this case the result is poor.

[Mediterranean boutonneuse fever. Apropos of 154 recent cases]. / La fièvre boutonneuse méditerranéenne. A propos de 154 cas récents.

The Mediterranean spotted fever is always present in the south of France. The actual incidence is unknown. The disease appears in summer. The diagnostic is based on the association of fever, "black spot" and exanthema and/or a seroconversion. Indirect immunofluorescence is the most used technique. Some patients have severe complications: neurologic, cardiovascular, renal, thrombopenia. These cases look like Rocky Mountain Spotted Fever. The treatment is based on tetracycline.

[Thrombocytosis and cancer. Apropos of a chronological series of 100 patients]. / Thrombocytose et cancer. A propos d'une série chronologique de cent malades cancéreux.

The authors report a personal chronological series of 100 cancer patients submitted to an analytical study, and noted thrombocytosis in 18% of cases. They attempt to draw up a correlation between the presence of increased platelets, and the site of the primary tumour, its spread, the state of anemia or iron deficiency in these patients. During a general review of the literature, they compare their results with those of various american and german series and report the various pathogenic hypotheses suggested upto date. They emphasise the fact that routine platelet counts may be of great interest in the detection of certain early carcinomas in spite of the generally moderate levels of thrombocytosis observed. They therefore have a place in routine health checks.