[Peripheral polyneuropathy after heat stroke]. / Polyneuropathie périphérique après coup de chaleur.

The authors report the case of a woman who developed a peripheral polyneuropathy after heat stroke. All the classical aetiologies of neuropathy were excluded. The final diagnostic was residual peripheral neuropathy provoked by heat stroke. The sequella of heat stroke are dominated by cerebellar compromise, but this case shows that peripheral polyneuropathies exist even if they are rare. They raise the issue of care because of severe neurological sequella.

[Organization of an operational site. Comparison of the durations of intervention planned and real]. / Organisation d'un site opératoire. Comparaison des durées d'intervention prévues et réelles.

OBJECTIVE: To improve planning of our operational site by comparing the durations of intervention scheduled by the surgeons and the real durations of occupation of room of intervention, surgical procedure and surgical operation. STUDY DESIGN: Prospective study carried out of December 8, 2003 to February 27, 2004. PATIENTS AND METHODS: Anaesthetic and surgical times of the interventions of visceral and gynaecological surgery were raised. From these data several durations were calculated like the duration of occupation of the room of intervention, surgical procedure and surgical operation. These durations were compared with the durations envisaged by the surgeons to carry out the planning of the operational activity. RESULTS: Two hundred and ten interventions were studied. The analysis showed that there was a significant difference between the duration planned and the real duration of occupation of the room of intervention 45 minutes [5-125] (p<0.0001). The duration planned corresponded with duration of surgical operation, duration which did not take into account anaesthetic induction and surgical installation. CONCLUSIONS: The effectiveness of the planning of an operational site depends on the exactness of the durations scheduled, which are used for its realization. It is significant that all the actors of the operating theatre suite use the durations closest to reality.

[Severe pneumococcal meningitis and ceftriaxone allergy]. / Méningite grave à pneumocoque et allergie à la ceftriaxone.

We report the case of a 51-year-old man with an allergy to amoxicillin/acid clavulanique who presented with Streptococcus pneumoniae meningitis. Initial treatment consisted of an association of antibiotics including ceftriaxone. Six days after treatment was initiated the patient developed skin reaction and the diagnosis of allergy to ceftriaxone was established by the dosage of specific IgE. Typically Streptococcus pneumoniae meningitis is treated with vancomycin and a third-generation cephalosporin. This association had to be modified because cross allergy to cephalosporins could have developed in this patient who had previously reacted to penicillins.

[Febrile coma and multiple organ failure: suspected hemoglobinopathy SC]. / Coma fébrile et défaillance multiviscérale: suspicion d'hémoglobinopathie SC.

We report the case of febrile fatal coma in a 51-year-old man from Burkina Faso. Magnetic resonance imaging (MRI) shows cerebral fat embolism. Haemoglobin electrophoresis shows probably haemoglobinopathy SC. A short review of the literature demonstrate the need to consider this complication in patients with neurological or respiratory disorders, in areas where this disease is highly prevalent, irrespective of age. It also emphasizes the diagnostic contribution of MRI and discusses the mechanism, the diagnosis as well as the difficulty of choosing the appropriate therapeutic course.

-The value of MRI in cerebral fat embolism-. / Intérêt de l'IRM dans l'embolie graisseuse cérébrale.

We report two clinical cases of cerebral fat embolism, thereby demonstrating the value of MRI.

[Magnetic resonance imaging during the acute phase of severe head injuries]. / L'imagerie par résonance magnétique (IRM) à la phase aiguë du traumatisme crânien grave.

In 1994, tomodensitometry is indispensable for diagnosis and treatment of acute head trauma. Magnetic resonance imaging (MRI) is more performant but not yet evaluated in this indication. Two homogeneous series of patients allow the authors to discuss interest and feasibility of MRI and to propose a new strategy for reception of acute head trauma.