When Enterococcus faecalis becomes a murderer.

We describe the case of a 64 years old patient, known for an Enterococcus faecalis endocarditis on a 25 mm Edwards-Carpentier biological aortic valve in 2020, who was re-hospitalized one year later in cardiac surgery for a recurrence of Enterococcus faecalisbacteriemia. During hospitalization, the patient presented a cardiac arrest. The coronarography revealed an acute occlusion of the left coronary artery. The autopsy confirmed an Enterococcus faecalis thrombus on aortic valve and left coronary artery. Although systemic embolism is a common complication of infective endocarditis, septic embolism is an unsual cause of acute coronary syndrome and a very rare cause of cardiac arrest. Our case highlights a rare and potentially fatal complication of infective endocarditis: acute coronary syndrome on septic coronary embolism.

[Toxin-infections and toxin-related diseases due to Clostridia other than Clostridium difficile]. / Toxi-infections et maladies toxiniques liées à des clostridies autres que Clostridium difficile.

Clostridia cause severe diseases. Tetanus is rare in Switzerland because of vaccine coverage and the application of guidelines for the management of contaminated wounds. Tetanus requires wound debridement and the administration of antibiotics and anti-tetanus immune. Besides gastroenteritis, infections due to C. perfringens most often require surgery, in addition to antibiotic treatment with penicillin and clindamycin. Botulism is a rare disease caused by a toxin produced by C. botulinum that causes flaccid paralysis. The clinical syndrome must be recognized early in order to administer the antitoxin and improve the prognosis. The other, rarer species of Clostridia require surgical and antibiotic management, but their prognosis remains poor.

Les clostridies causent des maladies graves. Le tétanos est rare en Suisse grâce à la vaccination et à l'application de directives pour la gestion des plaies souillées. Sa prise en charge nécessite un débridement de plaie, l'administration d'antibiotiques et d'immunoglobulines antitétaniques. En dehors des gastroentérites, les infections à C. perfringens nécessitent en règle générale une chirurgie, en sus d'une antibiothérapie par pénicilline et clindamycine. Le botulisme est une maladie rare due à une toxine produite par C. botulinum qui entraîne une paralysie flasque descendante. Le syndrome clinique doit être reconnu précocement afin d'administrer l'antitoxine et améliorer le pronostic. Les infections invasives dues à des espèces plus rares de clostridies nécessitent une prise en charge chirurgicale et l'administration d'antibiotiques, mais leur pronostic est défavorable.

Outbreak of Mycobacterium haemophilum infections after permanent makeup of the eyebrows.

We report a Mycobacterium haemophilum outbreak after permanent make-up of the eyebrows performed by the same freelance artist. Twelve patients presented an eyebrow lesion and cervical lymphadenitis. All were treated with antibiotics. Surgery was required in 10 cases. M. haemophilum DNA was identified in the make-up ink.