[First report of coccidioidomycosis associated with Sweet syndrome]. / Première association d'une coccidioïdomycose et d'un syndrome de sweet.

BACKGROUND: We describe the first reported case associating coccidioidomycosis and Sweet syndrome, two uncommon diseases in Europe. CASE REPORT: One month after traveling to Mexico, a 47-year-old woman developed a maculo-papulous rash on her trunk, neck and limbs. She also had cough, associated with signs of an upper respiratory tract infection and weight loss. Sweetís syndrome was first diagnosis and confirmed histologically on a skin lesion biopsy. An aspectific pulmonary infiltrate, associated with a left-sided paracardiac opacity was found on chest X-rays and the CT scan. Bronchoalveolar lavage products contained more than 60% lymphocytes. Serology using coccidioidin showed an F-precipitin on agar (IgM) and an IgG-titre of 1:8, leading to the diagnosis of primary Coccidioides immitis infection with a probable lung localization. DISCUSSION: Search for an associated disease should be made in patients with Sweet syndrome. The Sweet syndrome coccidioidomycosis association could be related to TH-1 lymphocyte proliferation.

Agrobacterium radiobacter bacteremia in oncologic and geriatric patients: presentation of two cases and review of the literature.

INTRODUCTION: We report here two cases of Agrobacterium radiobacter bacteremia. These cases were observed at the same institution over a short time period (3 months). CASE REPORTS: The first patient was a female cancer patient receiving third-line chemotherapy for ovarian carcinoma. When she developed bacteremia, she was neutropenic and had an indwelling catheter that was removed as part of the treatment. The second case was a geriatric patient admitted from home with bacteremia, clinical signs of septic shock, and concomitant acute cholecystitis. OUTCOME: Both patients responded promptly and completely to antibiotherapy. No recurrence was observed.

Reversible amnesia in a Type 1 diabetic patient and bilateral hippocampal lesions on magnetic resonance imaging (MRI).

AIMS: Intensive insulin therapy of Type 1 diabetes limits its chronic complications, but is associated with an increased risk of severe hypoglycaemia and its neuroglycopenic consequences. METHODS: Case report. RESULTS: A 24-year-old male with 15 years' history of Type 1 diabetes, who was missing for 48 h, was found at home in ketoacidosis coma. Intensive care permitted a rapid improvement revealing an unexpected severe anterograde amnesia, confirmed by neuropsychological testing. MRI performed 4 days after admission showed abnormal bilateral hyperintensity signals on T2-weighted images in the hippocampus. Three months later, the patient had nearly completely recovered and resumed work. MR images and neuropsychological testing returned to normal. CONCLUSIONS: The most likely course of events favours an initial prolonged hypoglycaemic coma following insulin overdose. The hippocampal injury may be a result of hypoglycaemia. Neuropsychological testing and MRI abnormalities were completely reversible. This case underlines the potential risks of intensive insulin therapy.

Saccharomyces cerevisiae fungemia in a head and neck cancer patient: a case report and review of the literature.

We report the case of a 65-year old male who developed Saccharomyces cerevisiae fungemia after completing a course of concomitant chemotherapy and radiation therapy for head and neck carcinoma. He had grade IV oral mucositis, and received Saccharomyces boulardii (Perenterol) orally as treatment for aseptic diarrhoea just before the onset of fungemia. We discuss the epidemiology and pathology of Saccharomyces cerevisiae in the cancer patient population.