[Infection due to Mycobacterium malmoense in an immunocompetent patient]. / Infection à Mycobacterium malmoense chez un patient immunocompétent.

INTRODUCTION: Mycobacterium malmoense (MM) is an atypical mycobacterium responsible for opportunistic infection. The clinical and radiological picture is non-specific. The infection develops most frequently in a dystrophic lung. CASE REPORT: A patient of 52 years was admitted with an extensive multifocal pneumonia which later proved to be due to infection with MM. Empirical treatment was started with the combination of rifampicin, isoniazid, pyrazinamide (rifater) and ethambutol (myambutol). Subsequently, cultures showed sensitivity to rifampicin, ethambutol, oxfloxacin, clarithromycin (MIC < 2 mg/l) and rifabutin (MIC < 0.5 mg/l). More than two weeks after the start of treatment, material aspirated at fibroscopy showed the persistence of numerous acid-alcohol fast bacilli, an increase, compared with the original examination, from 5 to 25 per field on day 2, to 20 to 100 per field on day 19. Despite the late addition of clarithromycin there was a progressive deterioration in the pulmonary condition. CONCLUSION: There is little correlation between the in vivo and in vitro sensitivities of MM to antibiotics. In our patient the progress was unfavourable, even though the mycobacterium was sensitive to the combination of antibiotics used, with the exception of isoniazid that was not tested. In vitro isoniazid does not seem to be active against MM. There is no consensus of opinion on the antibiotic treatment of MM infections.

[Traumatic hip dislocation with diaphyseal fracture of the femur in a 5-year-old girl]. / Luxation traumatique de la hanche avec fracture diaphysaire du fémur chez une enfant de 5 ans.

The author reports a very unusual association of a traumatic dislocation of the hip with a fracture of the ipsilateral femoral shaft in a five-year-old child. The review of the literature reveals that, in such cases, the dislocation was often missed at first. In the reported case, conservative reduction of the dislocation was not possible and surgical reduction was needed. Closed treatment was applied for the femoral fracture. After a four year follow-up, the child was completely normal with no limb length discrepancy. The orientation of the femoral neck was normal.

[Rupture of third duodenum (author's transl)]. / Rupture complète de 3e doudénum. Intervention. Guérison.

The authors report a case of complete rupture of the third duodenum after blind trauma of the abdominal wall. They discuss pre op diagnosis with amount to X ray findings; surgical management included resection of the left part of the 3rd duodenum, 4th duodenum, and 1rst jejunal loop, with latero terminal anastomosis of the lower part of the 2nd duodenum to the jejunum; uneventfull recovery.

[Conservative surgery of the spleen. 3 case reports]. / Chirurgie conservatrice de la rate. Trois observations.

Hemi splenectomy or partial splenectomy may appear as an opportunity for a splenic injury, to prevent further infections. Such preserved spleens are functional. Splenic conservation necessitates a transversal sub costal incision for an easy surgical treatment without splenic mobilisation.

[Leri's melorheostosis. Apropos of 3 cases in children]. / La mélorhéostose de Léri. A propos de trois observations chez l'enfant.

Three pediatric cases of Leri's melorheostosis are reported. Growth disorders and deformities of the limbs are often the first signs in children. X ray shows areas of very opaque condensation of the long bones parallel to the main axis of the bones parallel to the main axis of the bone, and on the epiphyses, small dense and irregular islets. The course is benign but there may be orthopedic complications.