Hypoxemic measles pneumonitis in an immunocompetent adult

peer reviewedMeasles is a highly contagious viral disease and one of the biggest causes of morbidity and mortality in the world. Transmission occurs from person to person through direct contact or by aerosolization of pharyngeal secretions. It can be responsible for severe respiratory and neurological complications. The diagnosis is clinical, confirmed by serology, PCR or culture of the measles virus. Treatment is symptomatic and prevention is based on a well conducted vaccination. In severe cases, the use of vitamin A is recommended by the World Health Organization, at least in chidren. Antivirals (ribavirin) have not been shown to be effective in clinical practice. We present a severe respiratory form of measles, affecting a young immunocompetent adult

encéphalite post-rougeoleuse chez un patient non-vacciné

peer reviewedMeasles is one of the most contagious diseases with, in 1/1000 case, an acute disseminated encephalomyelitis (ADEM) as complication for non-vaccinated population

Dissection de l’aorte thoracique compliquée d’un syndrome coro narien aigu: un piège diagnostique évitable

peer reviewedLa dissection aortique entreprenant les coronaires constitue un défi diagnostique car le tableau clinique peut être confondu avec un syndrome coronarien aigu en raison des anomalies électrocardiographiques souvent observées. Lorsque c’est le cas, le traitement chirurgical est retardé et un traitement anticoagulant, antiagrégant, voire fibrinolytique peut être erronément entrepris. Le score de détection de la dissection aortique permet d’identifier les patients à risque de dissection aortique. Nous rapportons le cas d’un patient de 60 ans décédé d’une dissection aortique avec tamponnade cardiaque. Le diagnostic initialement retenu étant celui d’un syndrome coronarien aigu, le patient avait été traité par héparine et acide acétylsalicylique. Ce cas illustre le piège diagnostique entre le syndrome coronarien «isolé» et celui associé à une dissection aortique. Nous en profitons pour refaire une revue des recommandations 2020 de l’European Society of Cardiology pour la prise en charge des NSTEMI

FLOATING THROMBUS IN THE AORTIC ARCH, A RARE CAUSE OF LOWER LIMB ISCHEMIA

peer reviewe

Rare Case of Ischaemic Stroke Following Cervical Transforaminal Injection

We report a case of brainstem infarction following a C5–C6 cervical transforaminal injection, a rare and serious neurological complication of this procedure. Cervical transforaminal steroid injection is a common therapy for patients with persistent cervical radiculopathy not relieved by conservative treatment, and is effective in 65–70% of cases. Unfortunately, this procedure may lead to serious complications such as neurological damage. These complications are rare but potentially fatal, as reported in our case. Complications could be due to three mechanisms: the technique itself, the cervical vascular anatomy and the properties of the product (corticoids). The neurological complications can be diagnosed through brain MRI. This case report focuses on the importance of a risk/benefit evaluation when performing this medical procedure

Fatal serotonin syndrome induced by Ecstasy consumption

peer reviewe

Highly Fluorescent Pyrene-Functional Polystyrene Copolymer Nanofibers for Enhanced Sensing Performance of TNT

A pyrene-functional polystyrene copolymer was prepared via 1,3-dipolar cycloaddition reaction (Sharpless-type click recation) between azide-functional styrene copolymer and 1-ethynylpyrene. Subsequently, nanofibers of pyrene-functional polystyrene copolymer were obtained by using electrospinning technique. The nanofibers thus obtained, found to preserve their parent fluorescence nature, confirmed the avoidance of aggregation during fiber formation. The trace detection of trinitrotoluene (TNT) in water with a detection limit of 5 nM was demonstrated, which is much lower than the maximum allowable limit set by the U.S. Environmental Protection Agency. Interestingly, the sensing performance was found to be selective toward TNT in water, even in the presence of higher concentrations of toxic metal pollutants such as Cd2+, Co2+, Cu2+, and Hg2+. The enhanced sensing performance was found to be due to the enlarged contact area and intrinsic nanoporous fiber morphology. Effortlessly, the visual colorimetric sensing performance can be seen by naked eye with a color change in a response time of few seconds. Furthermore, vapor-phase detection of TNT was studied, and the results are discussed herein. In terms of practical application, electrospun nanofibrous web of pyrene-functional polystyrene copolymer has various salient features including flexibility, reproducibility, and ease of use, and visual outputs increase their value and add to their advantage. © 2015 American Chemical Society

Abrupt Severe Chest Pain and Vomiting: Remember to Think of a Ruptured Oesophagus (Boerhaave Syndrome)

Boerhaave syndrome or spontaneous rupture of the oesophagus is a severe condition commonly misdiagnosed or unrecognized. Prognosis is poor even if the diagnosis is made promptly. We describe a case of Boerhaave syndrome diagnosed after the development of pneumomediastinum and cardiac arrest. Unfortunately, the patient died 48 hours after admission to the Intensive Care Unit. This entity requires a multidisciplinary management approach which may include conservative, surgical or endoscopic procedures

Spinal Cord Compression Secondary to a Spontaneous Cervical Epidural Haematoma

We report the case of an 86-year-old female patient with chronic neck pain who presented with an initial misleading clinical picture suggesting an ischaemic stroke. No recent or previous anticoagulation treatment or fall history was reported. The patient developed a paraplegia of the upper limbs needing magnetic resonance imaging which revealed a compressive cervical haematoma. The patient benefitted from cervical laminectomy and evacuation of the cervical haematoma. Motricity in upper extremities was recovered but paresis in the lower extremities persisted 1 week after surgical intervention

A Rare Case of Adult Acute Disseminated Encephalomyelitis Associated with Primary Epstein-Barr Virus Infection

We report a rare case of acute disseminated encephalomyelitis (ADEM) secondary to a primary Epstein-Barr (EBV) infection, in a 22-year-old male. Symptomatic infectious mononucleosis and ADEM are both quite uncommon conditions in this age group