[Bacterial and fungal co-infection: an association of criminals to look for]. / Co-infection bactérienne et fongique : une association de malfaiteurs à chercher.

INTRODUCTION: Mucorales are fungi that cause opportunistic infections. Its incidence increases. CASE REPORT: We report case of a 68-year-old woman with myelodysplastic syndrome responsible for prolonged neutropenia, hospitalized for pneumonia and sinusitis caused by Pseudomonas aeruginosa. But, despite antibiotic therapy, the patient's health deteriorated with discovery of systemic emboli on CT-scan and died. Sinus biopsies performed before her death diagnosed invasive fungal infection (Mucorales). CONCLUSION: Mucorales co-infections are rare but have already been described. Any invasive fungal infection should be searched on the event of any clinical suspicion: ground (neutropenia), lack of response to well-conducted antibiotic therapy, rapidly unfavorable outcome. The presence of other microbiological documentation do not must stop the search of invasive fungal infection, because it could have short-term life-threatening impact.

Evaluation of pneumococcal urinary antigen testing for respiratory tract infection investigations.

OBJECTIVE: The pneumococcal urinary antigen test enables rapid bacteriological diagnosis in respiratory tract infections. The objective was to identify factors associated with a positive pneumococcal urinary antigen test result. PATIENTS AND METHODS: This seven-year retrospective monocentric study was performed on consecutive patients presenting with respiratory tract infections reported as pneumococcal-positive. Epidemiological, biological, and radiological factors were analyzed, and severity scores were calculated. RESULTS: A total of 223 patients were included. Significant associations were observed between positive test results and age over 65years (P=0.01), positive test results and immunosuppression factors (blood disease [25% Ag+ group vs. 4% Ag- group, P=0.001], immunosuppressive therapy [10% Ag+ group vs. 0% Ag- group, P=0.02]). Clinically, fever (64% Ag+ group vs. 42% Ag- group, P=0.01) and cough (46% Ag+ group vs. 19% Ag- group, P<0.01) were associated with a positive result, as were radiological alveolar opacities (67% Ag+ group vs. 44% Ag- group, P=0.01). High PSI score was associated with the Ag+ group (79% vs. 56% Ag- group, P=0.001). CONCLUSION: Age, immunosuppressive factors, typical pneumococcal symptoms, and PSI scores were associated with a positive pneumococcal urinary antigen result.

[Mycobacterial pulmonary infection due to Mycobacterium simiae]. / Mycobactériose pulmonaire à Mycobacterium simiae.

INTRODUCTION: Mycobacterium simiae pulmonary infections remain exceptional in France. CASE REPORT: We report a case of M. simiae lung infection and a 10-year follow-up in a non-immunocompromised host. CONCLUSION: This case emphasizes the difficulties of choosing the appropriate drugs and their side effects in the absence of any existing gold standard.