Cutaneous Larva Migrans.

BACKGROUND: Cutaneous larva migrans (CLM) is a helminthic infection found in tropical areas. It is commonly seen in patients in contact with soil contaminated by cat and dog hookworm larvae. CLM manifests as an erythematous, serpiginous, and pruritic cutaneous eruption. We present a case of a 27-year-old female with a serpiginous lesion on the plantar surface of the right foot. METHODS AND RESULTS: The patient was prescribed Albendazole at 400 mg twice a day for three days. After treatment, the lesion and pruritus have decreased in severity. CONCLUSIONS: Hookworm-related CLM is diagnosed clinically based on the typical clinical presentation. Clinicians need to be aware of the possibility of hookworm-related CLM with a history of travel to tropical areas, especially walking barefoot.

Dynamique de la prise en charge thérapeutique et préventive de la Covid-19 chez les patients adultes vulnérables / Dynamics of therapeutic and preventive management of Covid-19 in vulnerable adult patients

La pandémie à Covid-19 continue sa progression et interpelle aujourd'hui toute l'humanité particulièrement le corps médical. A la date du 30 Juin 2020, le monde entier compte 10185374 cas confirmés avec 563862 décès [1]. La recherche scientifique intense a pu rapidement séquencer ce virus à ARN, partager sur sa clinique et son évolution. Mais six mois après il persiste encore beaucoup d'inconnues concernant son pouvoir pathogène, sa physiopathologie mais surtout sa prise en charge thérapeutique particulièrement chez les sujets âgés ou ayant des facteurs de risqué qui ont une mortalité significativement plus élevée [1, 2, 3]. La Covid-19 pose ainsi un problème de prise en charge thérapeutique chez les sujets vulnérables. Cette situation préoccupante pour tous, justifie la poursuite de la réflexion, de la recherche et surtout le partage d'expériences pour une meilleure prise en chargechez ces patients à risque

Dysphagia as an Unusual Presentation of Myeloma.

Multiple myeloma is a plasma cell dyscrasis characterized by mature B cells proliferation in the bone marrow. In rare cases, the disease can present as an extramedullary location, making diagnosis and management more challenging. Here, we describe a rare case of tongue extramedullary myeloma and discuss diagnostic, prognostic, and therapeutic issues.

[Skeletal manifestations in Behçet's disease. A report of 79 cases]. / Les manifestations articulaires de la maladie de Behçet. A propos de 79 cas.

PURPOSE: Our aim is to describe the skeletal manifestations of Behcet's disease (BD) among young adults in a military population. METHODS: We conducted a retrospective study of 176 patients with BD who were followed between 1980 and 2005. All the patients fulfilled the international study group on Behcet's disease diagnostic criteria. RESULTS: Rheumatic manifestations were noticed in 79 out of 176 patients (45%), ranking second after the skin and mucosal manifestations of the disease. Articular manifestations were the first disease manifestation in 16.5% of the patients. Inflammatory arthralgias were the most common manifestation and observed in 81%, interesting mainly the large lower limb joints. Disease course was acute in most of the patients. Arthritis was less common: oligoarthritis (7.5%), monoarthritis (6.5%) and polyarthritis (5%). Axial involvement was also noted: spine pain in 29%, isolated sacroiliitis in 7.5%, and definite ankylosing spondylitis in 5%. CONCLUSION: Joint involvement is common in BD and could be the first manifestation of the disease. Most of the patients present with inflammatory arthralgias of the large lower limb joints. Disease course is usually favourable, spontaneously or with treatment. However, in our study population, skeletal manifestations were responsible for significant disability.

[Diagnosis of anemia in alcoholic cirrhosis]. / Diagnostic des anémies au cours des cirrhoses alcooliques.

PURPOSE: Anemia in patients with alcoholic liver cirrhosis is a common issue. The diagnosis could be difficult because of the multiplicity of causes, usually associated, and specificities in the diagnostic approach. This subject has not been reviewed for almost two decades. We propose a review based upon analysis of the literature and our clinical experience. CURRENT KNOWLEDGE AND KEY POINTS: Because of the alcoholism and the biological consequences of the liver disease, laboratory findings, especially the mean corpuscular volume, should be interpreted with caution in the diagnostic approach. Despite these drawbacks, the diagnosis of anemia is detailed according to the usual plan: normocytic, macrocytic and microcytic anemias. Finally, we propose practical guidelines. FUTURE PROSPECTS AND PROJECTS: Further prospective studies should assess the real burden of nutritional deficiencies, easily treatable. The prognostic significance of hemolytic anemias in patients with alcoholic liver cirrhosis should be studied.

[Severe imported malaria. The experience of the military hospital of Marrakech]. / Le paludisme grave d'importation à propos de neuf cas: expérience de l'hôpital militaire Avicenne de Marrakech.

Incidence of severe imported malaria increases with the multiplication of humanitarian and military missions in malarial endemic areas. The purpose of this study was to describe the demographic, clinical, therapeutic and outcome aspects of 9 cases which have been hospitalized in the intensive care unit and medecine service of the military hospital of Marrakech, between january 2001 and december 2004. Out of 68 patients admitted with symptomatic malaria during this period, 9 cases were considered as severe. All of them were male soldiers (mean age: 33,3 years), 7 of them have stayed in Democratic Republic of Congo, and 2 in Ivory Coast. Chemoprophylaxis consisted in chloroquine plus proguanil in 5 cases and mefloquine in 4 cases. The mean duration of stay in endemic area was 9,3 months. The clinical presentation was dominated by troubles of consciousness, which justified initial admission in the intensive care unit. The mean duration of hospitalization was 3,3 days in intensive care unit and 5,6 days in the medical department. Thick smear always revealed high parasitemia (5-15%) with Plasmodium falciparum, associated with Plasmodium ovale in two cases. Antimalarial treatment consisted in quinine salts administration. Evolution was favourable without recurrence in 7 cases, but 2 deaths were recorded. Severe imported malaria remains associated with bad outcome and requires early diagnosis and close monitoring of such cases.

[Severe imported malaria: the experience of the Avicenna military hospital of Marrakech]. / Le paludisme grave d'importation à propos de neuf cas : expérience de l'hôpital militaire Avicenne de Marrakech.

Incidence of severe imported malaria increases with the multiplication of humanitarian and military missions in malarial endemic areas. The purpose of this study was to describe the demographic, clinical, therapeutic and outcome aspects of 9 cases which have been hospitalized in the intensive care unit and medecine service of the military hospital of Marrakech, between january 2001 and december 2004. Out of 68 patients admitted with symptomatic malaria during this period, 9 cases were considered as severe. All of them were male soldiers (mean age: 33,3 years), 7 of them have stayed in Democratic Republic of Congo, and 2 in Ivory Coast. Chemoprophylaxis consisted in chloroquine plus proguanil in 5 cases and mefloquine in 4 cases. The mean duration of stay in endemic area was 9,3 months. The clinical presentation was dominated by troubles of consciousness, which justified initial admission in the intensive care unit. The mean duration of hospitalization was 3,3 days in intensive care unit and 5,6 days in the medical department. Thick smear always revealed high parasitemia (5-15%) with Plasmodium falciparum, associated with Plasmodium ovale in two cases. Antimalarial treatment consisted in quinine salts administration. Evolution was favourable without recurrence in 7 cases, but 2 deaths were recorded. Severe imported malaria remains associated with bad outcome and requires early diagnosis and close monitoring of such cases.