Mounier-Kuhn syndrome and tracheopathia osteoplastica in the same patient with respiratory insufficiency

SummaryMounier-Kuhn syndrome (MKS) or tracheobronchomegaly, and tracheopathia osteoplastica (TO) are rare diseases. MKS is a clinical entity characterized by abnormal dilatation of the trachea and main bronchi. TO is a clinical and pathologic condition characterized by multiple submucosal cartilaginous and osseous nodules lining the upper respiratory tract. Some people with MKS manifest recurrent pneumonia or chronic cough with sputum production, hemoptysis or dyspnea. Occasionally, it is found in asymptomatic individuals. CT scan imaging is the key tool for the diagnosis when showing a dilatation of the trachea and main bronchi. TO is usually benign and asymptomatic, frequently diagnosed incidentally during intubation. Flexible fiberoptic bronchoscopy and laryngoscopy are the key diagnostic tools which typically demonstrate irregular spicules of submucosal bone and cartilage projecting into the tracheobronchial lumen and causing various degrees of airway obstruction. When this aspect is found bronchial biopsy is not mandatory. We report the case of a 26-year-old man with features of both MKS and TO who presented a previous history of productive cough, recurrent pneumonia and dyspnea; admitted for pulmonary infection resulting in a respiratory insufficiency. MKS was diagnosed by CT scan and TO by fiberoptic bronchoscopy. To our knowledge, this is the first time these pathologies are reported in the same patient, and our patient is the second one having MKS who presented with respiratory insufficiency

Venous thromboembolism risk and prophylaxis in the acute hospital care setting-results of the Endorse study in Tunisia

BACKGROUND: There are not information about the risk of venous thromboembolism (VTE) and its prophylaxis in Tunisia. AIM: To report the Tunisian results of a multinational crosssectional study, designed to assess the prevalence of VTE risk in the acute hospital care setting and to determine the proportion of at risk patients who receive effective prophylaxis. METHODS: All hospital inpatients aged 40 years or over admitted to a medical ward or these aged 18 years or over admitted to surgical ward, in 5 Tunisian hospitals were assessed for risk of VTE on the basis of hospital chart review. The 2004 American College of chest physicians (ACCP) evidence based consensus guidelines were used to assess VTE risk and to determine whether patients were received recommended prophylaxis. RESULTS: 885 were enrolled, 212 (24%) were surgical and 673 (76%) were medical. 408 (44, 9%) judged to be at risk, 95 (44, 8%) are surgical and 313 (46, 5%) are medical. LWMH are the most used. Mechanical prophylaxis was never used. CONCLUSION: The percentage of at risk patient in Tunisia is comparable to these of other countries. The majority of at risk patient are medical. The prophylaxis was under used. Hospital strategies to assess patient VTE risk and implementation of prophylaxis protocols are needed

pneumonia in a healthy immunocompetent patient: A case report and literature review

Pneumocystis jirovecii pneumonia, typically an opportunistic infection, is commonly associated with risk factors such as low CD4+ lymphocyte count, underlying malignancies, organ transplantation, or immunosuppressive medications. However, occurrences in healthy individuals without known risk factors are exceptionally rare and sparsely documented. In our retrospective analysis of a 42-year-old male without past medical history at Abderrahmane Mami Hospital, Tunisia, Pneumocystis jirovecii pneumonia was diagnosed. The patient presented with fever, productive cough, hemoptysis, and a decline in general health. Clinical examination revealed fever and hypoxemia, and imaging studies demonstrated bilateral necrotic alveolar opacities. Despite empirical antibiotics, nonresponse necessitated bronchoscopy, confirming Pneumocystis jirovecii . Treatment with oral Sulfamethoxazole-Trimethoprim yielded excellent outcomes. This case highlights the potential occurrence of Pneumocystis jirovecii pneumonia in immunocompetent individuals, underscoring the importance of direct microbiological methods in assessing suggestive clinical and radiological features

Bullous dermatosis associated with gemcitabine therapy for non-small-cell lung carcinoma

SummaryGemcitabine considered is to be a well-tolerated cytostatic drug with little known side effects. Cutaneous reactions are well known but still rarely reported.We report the case of a 75-year-old man with stage IV non-small-cell lung carcinoma treated with combination of gemcitabine 1000mg/m2 and cisplatin 75mg/m2 repeated every 28 days, who developed bilateral cutaneous bullous lesions of lower limbs following gemcitabine administration. Histopathologic examination did not show any toxidermy aspect and there was not any sign of immunoglobulin deposit in direct immunofluorescence test. Chemotherapy was stopped and lesions disappeared without any treatment. Even delayed with regard to gemcitabine administration, the causal relationship of gemcitabine treatment with skin reaction is possible according to the Naranjo probability scale. Pathologists should be aware of this kind of side effect in managing chemotherapy drugs and report any dermatologic reactions in order to identify the cause of toxicity and avoid a misdiagnosis

In vitro scolicidal activity of Thymus capitatus Hoff. et Link. essential oil on Echinococcus granulosus protoscoleces

Cystic echinococcosis remains a serious public health problem worldwide. Surgery is considered as the first option of treatment. Various investigations were carried out to find a convenient scolicidal agent for reducing the risk of post-surgical recurrence of the disease but most of them are associated with adverse side effects. The present study aimed to evaluate the in vitro scolicidal activity of Thymus capitatus Hoff. et Link. essential oil against Echinococcus granulosus protosco- leces. Three concentrations of essential oil (1, 2 and 3 mg/mL) were tested for 1 to 10 min on E. granulosus protosoleces and their viability was assessed by eosin staining test. The essential oil concentrated at 2 and 3 mg/mL killed 100% protoscoleces after 5 and 1 min, respectively. Furthermore, GC/MS and GC-FID analyzes indicated that carvacrol (82.4%) was the major compo- nent of the essential oil. The current investigation showed the potent scolicidal effect of T. capitatus essential oil in vitr

Genome analysis provides insights into crude oil degradation and biosurfactant production by extremely halotolerant Halomonas desertis G11 isolated from Chott El-Djerid salt-lake in Tunisian desert

Here, we report the genomic features and the bioremediation potential of Halomonas desertis G11, a new halophilic species which uses crude oil as a carbon and energy source and displays intrinsic resistance to salt stress conditions (optimum growth at 10% NaCl). G11 genome (3.96 Mb) had a mean GC content of 57.82%, 3622 coding sequences, 480 subsystems and 64 RNA genes. Annotation predicted 38 genes involved in osmotic stress including the biosynthesis of osmoprotectants glycine-betaine, ectoine and osmoregulated periplasmic glucans. Genome analysis revealed also the versatility of the strain for emulsifying crude oil and metabolizing hydrocarbons. The ability of G11 to degrade crude oil components and to secrete a glycolipid biosurfactant with satisfying properties was experimentally confirmed and validated. Our results help to explain the exceptional capacity of G11 to survive at extreme desertic conditions, and highlight the metabolic features of this organism that has biotechnological and ecological potentialities