Vertebral cryptococcosis in an immunocompetent patient - a case report

We report an unusual case of 70 years old, immunocompetent woman who was diagnosed with vertebral cryptococcosis. The diagnosis was made on the basis of radiological and histological findings. The outcome was favorable under antifungal treatment

Méningite récurrente révélant une maladie de Behçet: à propos de deux cas

Les étiologies des méningites sont surtout infectieuses. Les causes non infectieuses, sont souvent de  diagnostic difficile et incertain, tel est le cas de la maladie de Behçet. Nous rapportons deux observations de patients ayant présenté des épisodes récurrents de méningite. Dans un premier temps, la suspicion d’une étiologie infectieuse a conduit à introduire un traitement anti-infectieux probabiliste. La découverte à posteriori d’une aphtose bipolaire a permis de poser le diagnostic de maladie de Behçet. Une corticothérapie s’est révélée efficace. La maladie de Behçet doit toujours faire partie des diagnostics différentiels des méningites récurrentes.Key words: Méningite récurrente, maladie de Behçet, neuro-Behçe

Churg-Strauss syndrome associated with AA amyloidosis: a case report

Churg Strauss syndrome is a rare systemic and pulmonary vasculitis exceptionally associated with AA amyloidosis. We report the case of a 65-year old woman with past medical history of asthma. She developed polyarthralgia, headache and purpura. A laboratory workout found hypereosinophilia (1150/μL), positive p-ANCA, microscopic haematuria and proteinuria at 2g/day. A diagnosis of Churg-Strauss syndrome was established based on five criteria of the American College of Rheumatology (ACR). Renal biopsy showed an important type AA amyloid deposit. The patient was treated with steroids with a good response of the vasculitis and amyloidosis with disappearance of the proteinuria.Pan African Medical Journal 2012; 12:3

Meckel’s diverticulum causing intestinal obstruction in the newborn

The causes of neonatal bowel obstruction are variable and dominated by malformations and the Meckel diverticulum must remain exceptional. We report a case of neonatal bowel obstruction in a six day old male neonate admitted on account of inability to pass stool, abdominal distension and bilious vomiting. The radiologic additional examinations are non-specific. Exploratory laparotomy found obstruction at the site of a Meckel's diverticulum

L’épiphysiolyse fémorale supérieure chez un malade en paralysie cérébrale suite à une crise convulsive

L'épiphysiolyse fémorale supérieure (EFS) correspond à un glissement de l'épiphyse fémorale supérieure par rapport au col fémoral qui le plus souvent se fait en arrière et en dedans, sous l'effet du poids du corps. Cette affection survient le plus fréquemment lors de la puberté. Nous rapportons le cas d’un enfant atteint de paralysie cérébrale avec spasticité des quatre membres, ce qui représente une entité très rare

Surgical treatment of developmental dysplasia of the hip in children – A monocentric study about 414 hips

Introduction: No consensus exists about the open reduction of developmental dysplasia of the hip (DDH; age of surgery and the need for additional bone surgery). We report clinical and radiological outcomes of a large monocentric study. The objectives are to analyze outcomes and to give recommendations. Materials and methods: This was a retrospective review of 414 hips (301 patients) operated on for DDH between 2010 and 2018. The mean age at the time of surgery was 34.6 months (14–96 months). In all, 72 hips had open reduction (OR) alone, 130 had OR with femoral osteotomy, 37 had OR with pelvic osteotomy, and 175 hips OR was associated with femoral and pelvic osteotomy. The mean follow-up was 6.5 years (3–10 years). Clinical outcomes were evaluated according to Mckay’s classification. The acetabular index was measured, and Severin classification was used for radiological outcomes. Reduction failure and residual dysplasia were noted, and avascular necrosis of femoral head (AVN) was assessed according to Kalamchi and MacEwen classification. Results: At the last follow-up, 331 hips (80.2%) had good clinical results, and 319 (77%) had satisfactory radiological results. The AI measured on the last follow-up radiograph was ≤25° in 350 hips. AVN was noted in 83 hips (20%). Redislocation was founded in 53 hips (12%). Overall: 293 hips (72%) had stable reduction without AVN with good clinical and radiological outcomes. Discussion: Clinical outcomes are better and the risk of AVN decreases significantly when a femoral osteotomy is performed. There were better radiological results when pelvic osteotomy was performed. The rate of residual dysplasia was higher when pelvic osteotomy was not performed. We recommend a femoral shortening osteotomy for high dislocations (Tönnis 3 or 4) for children over 18 months and a pelvic osteotomy for children over 36 months or over 18 months with an acetabular index > 25°

Conduite à tenir devant la découverte d’une gammapathie monoclonale à l’électrophorèse des protéines

La découverte d’un pic monoclonal lors d’une électrophorèse des protéines sanguines impose de réaliser un bilan biologique et radiologique afin d’éliminer en priorité une hémopathie maligne. Lorsque ce bilan complémentaire est négatif, on parle alors de gammapathie monoclonale de signification indéterminée (GMSI). Le diagnostic de GMSI implique une surveillance régulière afin d’identifier précocement les signes de transformation maligne

Hoffa's fracture of the medial femoral condyle in child

Hoffa's fracture is defined as a fracture of the femoral condyle in the coronal plane. It's more common in the lateral condyle and often described in adult. We report a rare case of Hoffa's fracture of medial condyle in immature skeleton in 10-year-old girl. The diagnosis was suspected in the X-Ray and confirmed by CT-scan. The patient was treated by open reduction and internal fixation. At two years follow up, the clinical and radiological outcomes were good.Hoffa's fracture of the medial condyle is exceptional in paediatric population. Diagnosis can be missed requiring CT-scan confirmation. The reduction of this fracture must be anatomical to prevent complications