Cerebral nocardiosis with osteomyelitis of skull vault complicating a primary neck lesion in an immunocompetent patient: a case report.

Nocardia infection is an uncommon and rare condition in immunocompetent patient. A case of cutaneous nocardiosis complicated with osteomyelitis of the vault scalp in a 64-year-old man, with no remarkable past medical history, is reported. Treatment with trimethoprime-sulfamethoxazole than doxycycline for 12 months led to complete resolution and no evidence of recurrence was noted. Nocardia infection should be considered even in immunocomptent patients and doxycycline is a good alternative for treatment.

Concomitant Mediterranean spotted fever and systemic lupus erythematosus: a rare case report.

Infections are an important cause of morbidity and mortality in Systemic Lupus Erythematosus (SLE). Mediterranean spotted fever (MSF) is a tick-borne disease caused by Rickettsia conorii. This infection is endemic in Tunisia with summer seasonality. Herein, the case of a 45 years old woman, admitted to hospital with fever and erythema nodosum. On examination, she had a diffuse skin rash, malar rash, and polyarthritis. Serology demonstrated Rickettsia Conoriiinfection. The diagnosis of MSF was made and the patient had a course of doxycycline for 5 days with a prompt improvement of the fever, the skin lesions but she had a persistent malar rash, polyarthritis, and lymphopenia. The immunological profile was positive for antinuclear antibodies (ANA), anti-DNA antibodies, anti-nucleosomes antibodies, and anti-citrullinated protein antibodies (ACPA). The diagnosis of SLE was established. We report the first case of SLE associated with MSF and with erythema nodosum as the initial presentation.

Meglumine antimoniate-induced DRESS: original case with a positive skin test.

We report a case of a 64-year-old woman treated with meglumine antimoniate (Glucantime®). On day 20, she developed fever, a pruriginous skin rash and myalgia. The blood tests showed eosinophilia and hepatic cytolysis. The clinico-biological picture improved gradually and the symptoms disappeared 4 weeks after the drug withdrawal. Six weeks later, intradermal tests to Glucantime® were performed and were positive at 48 hour-reading. This clinical picture suggests DRESS induced by meglumine antimoniate. To the best of our knowledge, only one case of meglumine antimoniate-induced DRESS has been reported in the literature and we are the first to report a case confirmed by skin tests.

Successful treatment of postoperative multidrug-resistant Acinetobacter baumannii meningitis by tigecycline.

Tigecycline is a broad-spectrum antibiotic with activity against multidrug-resistant (MDR) bacteria. It has limited indications. Studies are necessary to elaborate new guidelines. Here we report a case of postoperative MDR Acinetobacter baumannii meningitis treated by tigecycline combined with colimycin for 21 days. The treatment was well tolerated with a favourable outcome. In conclusion, tigecycline was shown to be effective in a case of MDR A. baumannii meningitis.