Atypical hypopigmentation of the face revealing a paucibacillary leprosy

Stéphanie Olivier, Marie Baeck, Anne Herman, Liliane Marot, Laurence de Montjoye Published in the journal : January 2018 Category : Dermatology

Paucibacillary leprosy generally occurs as one or several hypopigmented macules with sensory loss. Given the small number of Hansen’s bacilli in these lesions, neither the skin smear nor the pathology is able to bring out bacilli. Diagnosis is therefore mainly based on clinical manifestation in association with a compatible granulomatous histopathology.

Read more

A tetanus diagnosis in a patient with appropriate anti-tetanus serology

Dominique Henrion, Laurence Delbrassinne Published in the journal : January 2018 Category : Maladies infectieuses

We have here reported on an elderly patient who developed tetanus in spite of appropriate protective antibody levels. The clinical diagnosis could, however, not be confirmed by laboratory tests. A brief review on tetanus is provided, with the concluding remarks highlighting the necessity of regular vaccinations, even though vaccine escape may at times occur

Read more

Spontaneous and recurrent pneumothorax revealing pulmonary Langerhans cell histiocytosis: clinical case report and literature review

Anne-Louise Kollegger(1), Vi Doan(2), Geneviève Derue(3) Published in the journal : January 2018 Category : Pneumology

Langerhans cell histiocytosis is a rare disease that at times presents as an infiltrative lung disease, especially among smokers. We have herein reported the case of a young woman, who had been treated for histiocytosis in her childhood, presenting with spontaneous pneumothorax. CT scan revealed pulmonary Langerhans cell histiocytosis. A second pneumothorax episode with a permanent air leak made surgical treatment necessary. Given that the pneumothorax recurred, with the lung failing to expand, we conducted a literature review on this issue. This review revealed pneumothorax to occur in 10-20% of adult patients presenting pulmonary histiocytosis, with a high rate of recurrence.

Read more

Transcutaneous posterior tibial nerve stimulation (TPTNS) in managing urinary incontinence

Nathalie Bredohl(1), François Pallatzky(2), Lauranne Goffioul(3), Florence Manto(4), Jean-François Fils(5), Jean-François Kaux(6) Published in the journal : January 2018 Category : Physical and Rehabilitation Medicine

Up to 25% of women may be affected by urinary incontinence. Peripheral stimulation of posterior tibial nerve in the retromalleolar region can be proposed in certain cases of urinary incontinence. In this report, we conducted a follow-up on 268 patients suffering from incontinence and treated by the means of neuromodulation. The study analysis demonstrated significant success rates in patients with stress urinary incontinence, as well as in those with mixed incontinence.

Read more

Specificity of twins’ attachment and influence on their developpment

Marie-Laure Colaiacovo Published in the journal : January 2018 Category : Psychiatrie infanto-juvénile

This study has focused on the specificity of twins’ attachment, along with its impact on their development. To this end, adult twins were invited to revisit the experience of their relationship. When analyzing these testimonies, differences in the process and rhythm of twin empowerment compared to the singular child became apparent. Based on these findings, new practical recommendations pertaining to educating twins can be outlined. One can, thus, challenge the widely held assertion that it is crucial to "untwin" the twins at any price.

Read more

Pulmonary ascites in a train controller

Ha Mo Linh Lê (1), Patrick Gohy (1), Aude Schillaci (2), Didier Deltour (2), Andoni Laka (3), Patricia Schatt (4), Philippe Machiels (1) Published in the journal : December 2017 Category : Maladies infectieuses

The diagnosis of peritoneal tuberculosis is often delayed, given that this clinical condition has become rare in developed countries, while its presentation often proves to be indolent, with non-specific clinical features. In addition, the tests used to diagnose peritoneal tuberculosis do not enable us to distinguish this pathology from other abdominal diseases. Ziehl-Neelsen staining and polymerase chain reaction (PCR) analysis are not always sensitive. Culture growth can take up to 2 months before yielding results. While quick alternative non-invasive tests, such as plasmatic adenosine deaminase levels, may prove useful for diagnosis, laparoscopy remains the gold standard for peritoneal tuberculosis, allowing for both direct examination and tissue sampling in view of culture and histologic analysis.

Read more

Listeria monocytogenes is a rare cause of bacterial peritonitis, associated with poor prognosis. Appropriate antibiotic therapy may limit the damage

Melina Terrana, Laurence Faugeras, Anne-Caroline Courtois, Lionel D’Hondt (1) Published in the journal : December 2017 Category : Maladies infectieuses

Spontaneous bacterial peritonitis affects approximately 30% of hospitalized cirrhotic patients (1). Similar cases have been reported in patients suffering from carcinomatous ascites or receiving peritoneal dialysis (2). The most common pathogens are E. coli, Klebsiella pneumonia, Streptococci spp, and Enterobacteriaceae spp (3). In a minority of cases (<5%), other microorganisms are found, such as Candida, anaerobic bacteria, and Listeria (3). Only 108 cases of PSB Listeria have been reported in the scientific literature since 1977 (4). Identifying these cases proves paramount, because they are mainly resistant to cefotaxime (5).

Read more

Clinically silent corticotroph tumor revealed by galactorrhea

Caroline Fobe (1), Etienne Marbaix (2), Thierry Gustin (3), Etienne Delgrange (4) Published in the journal : December 2017 Category : Endocrinology

Galactorrhea associated with a sellar mass results in a large differential diagnosis. We discuss the case of a female patient harboring an invasive macroadenoma upon MRI, clinically associated with galactorrhea and mild hyperprolactinemia. The discrepancy between the large tumor size and mild prolactinemia, as well as the rapid normalization of prolactinemia under cabergoline without associated tumor volume reduction were considered arguments pleading against the lactotroph tumor diagnosis. Despite the lack of hypercortisolism-related clinical symptoms, with normal free urinary cortisol levels and normal cortisol suppression under dexamethasone, a silent corticotroph adenoma was suspected preoperatively, owing to the mildly-elevated ACTH levels in contrast with normal cortisol levels.

Read more

Yesterday, today and tomorrow : Advanced dermatology in heritage

Stéphanie Olivier, Diane Declaye, Jean-Marie Lachapelle, Marie Baeck, Dominique Tennstedt (1) Published in the journal : December 2017 Category : Dermatology

The PEAU’se Dermatology meeting held on March 21, 2016 focused on the understanding of dermatology in the past, present, and future, or, in other words, how the dermatology of the past has shaped the dermatology of today and will further shape the dermatology of tomorrow. Professor Emeritus Jean-Marie Lachapelle shared his experience on controversial pathologies, such as interstitial granulomatous dermatitis, nummular eczema, and Paederus dermatitis. Thereafter, the dermatology team from Cliniques universitaires Saint-Luc provided a series of "tips and tricks" to be remembered in daily dermatology practice.

Read more

Management of Jehovah’s witnesses before, during and after high bleeding risk surgery

Virginie Faucon, Mona Momeni(1), Patrice Forget(2) Published in the journal : December 2017 Category : Anesthesiology

Jehovah witnesses refuse transfusion of labile blood products. This is the reason why blood conserving procedures must be implemented when high bleeding risk surgery is required. Management of these patients consists in a multidisciplinary approach involving the anesthesiologist, intensivist, surgeon, and general practitioner. The procedures have to be initiated as soon as possible and be pursued during the entire hospitalization, while following a specific legal framework. This article provides a series of rules enabling doctors to properly care for their patients.

Read more