[Disseminated cutaneous and visceral fusariosis in an aplastic patient: an unusual digestive entry]. / Fusariose cutanée et viscérale disséminée chez un malade en aplasie: une porte d'entrée digestive inhabituelle.

INTRODUCTION: The hyalohyphomycetes, Fusarium spp, are very common in our environment. Some of them have been recognized as being opportunistic agents responsible for localized as well as generalized infections, especially in the case of malignant blood diseases. Their poor sensitivity to standard antifungal therapeutics makes them very dangerous. We report a case of cutaneous and systemic fusariosis due to Fusarium moniliforme in a patient with acute lymphoblastic leukemia. CASE-REPORT: A 20 year-old male student was suffering from acute type 6 myeloblastic leukemia. During the second consolidation schedule with a combined therapy of aracytine and amsacrine, this patient whose food diet was exclusively based on cereals, showed evidence of febrile aplasia, associated with myalgia, abdominal pain and diarrhoea. Microbiological samples were sterile. Ten days later, we noted the appearance of painful, diffuse and purple dermohypodermal cutaneous nodules surrounded by an erythematous ring. Histological and microbiological examination of the hypodermis biopsies of the skin nodules revealed invasion by Fusarium moniliforme. Treatment with voriconazole in association with transfusions of leukocytes led to clinical and microbiological cure. DISCUSSION: In our case report, the clinical pattern starting with digestive symptoms suggested dissemination from a digestive site, which is very unusual in Europe. In our patient, the malnutrition, together with a diet exclusively based on contaminated cereals in a context of malignant hemopathy, resulted in the colonization of the digestive tract by these moulds and the aplasia-inducing chemotherapy schedules enhanced their pathogen potential.

[Rhabdomyosarcoma of the thoracic wall in an adult. Apropos of a case]. / Rhabdomyosarcome de la paroi thoracique chez un adulte. A propos d'un cas.

Rhabdomyosarcoma is a malignant tumour generally observed in children or adolescents; thoracic localization is rare. The authors report a case of embryonary rhabdomyosarcoma of the thoracic wall in a 36-year-old subject. Pathology examination of surgical specimens confirmed the diagnosis. Treatment included surgical exeresis together with pre- and post-operative chemotherapy combining doxorubicine (40 mg/m2/cycle), ifosfamide (6 g/m2/cycle) and dacarbazine (900 mg/m2/cycle). Local recurrence, requiring radiotherapy, was observed a few months later and led to the patient's death after a 9-month clinical course.

[Association of IgA linear dermatitis and non-Hodgkin's malignant lymphoma]. / Association d'une dermatose à IgA linéaire et d'un lymphome malin non hodgkinien.

The association between linear IgA dermatosis and neoplasia has been the subject of several publications which suggest that the association is not fortuitous. We report a new case in which a non-Hodgkin's lymphoma was associated with a linear IgA dermatosis and underline the need for full evaluation in search of an associated neoplasia. However, the neoplasia-LAD association is not a true paraneoplastic syndrome since the two pathologies seldom follow a parallel course.

[Acute post-gravidic Budd-Chiari syndrome. One case (author's transl)]. / Syndrome de Budd-Chiari aigu post-gravidique. Une observation.

The sixth case of post-gravidic Budd-Chiari syndrome is reported. In the acute stage of the disease heparin seems to have given immediate favourable results, and the value of long-term heparin treatment is discussed. Post-mortem findings seven years after the acute episode confirmed the evolution towards a certain type of cirrhosis characterized by macroscopically and histologically heterogenous lesions and by persistent liver congestion. Portal hypertension was associated with arterialization of the portal vein and considerable dilatation of the right diaphragmatic veins. The venous drainage of the liver had undergone complex alterations: the supra-hepatic veins were affected with fairly recent incomplete ostial thrombosis, many intra-hepatic veins were reduced to a vestigial reticulum and others were the seat of recent or old re-canalized thrombosis. Cancerous transformation was found to be present in the larger hepatic nodules.