[Tableau d'insuffisance cardiaque congestive révélant une myocardite lupique : cas clinique]. / Lupus myocarditis presenting as acute congestive heart failure : A case report.

Systemic lupus erythematosus (SLE or lupus) is a disease in which the immune system attacks healthy cells and tissues throughout the body. Lupus myocarditis is a life-threatening condition, observed clinically in 3-9 % of patients with SLE. We report the case of a patient followed for multisystem SLE, presenting with de novo heart failure with severe left ventricular dysfunction revealing lupus myocarditis.

Cerebral meningioma during pregnancy mimicking eclampsia: About a rare case.

INTRODUCTION: Pregnancy is a physiological state whose association with any pathology gives it specific characteristics in the management of patients. Meningioma is the most frequent brain tumor but rarely develops during pregnancy. Treatment of the tumor generally follows the same principle as that proposed outside pregnancy, with priority given to the mother's life. PRESENTATION OF CASE: We report a rare case of gestational meningioma that was wrongly attributed to prepartum eclampsia, in a poorly monitored pregnancy estimated at 34 weeks' amenorrhea, which resulted in the termination of the pregnancy by cesarean section for maternal rescue. The patient underwent complete surgical removal of the tumor postpartum. DISCUSSION: Cerebral meningioma in pregnancy is a rare but often fatal disease characterized by unusual behavior compared to meningiomas in non-pregnant women. It is suspected that endocrine and vascular changes play a crucial role in the pathophysiology of rapid tumor growth during pregnancy. The tumor's harmful effect on the fetus is not direct but is mediated by its consequences, such as intracranial hypertension and epileptic seizures, which can be life-threatening for both mother and fetus and in some cases necessitate termination of pregnancy. CONCLUSION: The management of cerebral meningioma during pregnancy must take into account the gestational-fetal pairing, both in diagnosis and treatment. This requires close coordination and collaboration between various experts, including anesthetists, obstetricians, neurosurgeons, and pediatricians.

Surgical management of a transverse vaginal septum: About a rare case.

INTRODUCTION: The transverse vaginal septum is a rare anomaly of the müllerian ducts whose pathophysiology is linked to a defect in the resorption of the embryological tissue located between the vaginal dome and the caudal terminal part of the fused müllerian ducts. CASE PRESENTATION: We report a rare case of a permeable transverse vaginal septum in a 41-year-old patient, who consulted for cyclic pelvic pain. DISCUSSION: The vaginal septum is a rare anomaly of the Müllerian ducts whose approximate frequency is around 1/70,000 women. The vaginal septum can be permeable or impermeable and can affect all levels of the vagina. The combination of conventional ultrasound and MRI confirms the diagnosis of these abnormalities. The treatment is surgical and must be implemented quickly. Several surgical techniques have been described, the simplest of which is the "crevice" technique. CONCLUSION: The combination of conventional ultrasound and MRI is useful in confirming the diagnosis of these abnormalities. Surgical treatment should always be well planned. The risks of postoperative stenosis and the impact on the upper genital tract must be taken into account.

Unusual primary location of non-Hodgkin lymphoma in the uterine body with compressive form: About case.

INTRODUCTION: Primary non-Hodgkin's malignant lymphoma (NHML) of the uterine body is an extremely rare localization since only eleven cases have been reported in the literature. CASE PRESENTATION: We report a case of primary NHML of the uterine body discovered during a hysterectomy performed for a uterine mass. The primary character of NHML of the uterine body was retained in view of the absence of extra-genital localization in the clinical, biological and radiological workup (Ann Arbor stage IE) and there were no signs of recurrence during follow-up. The patient received anti-CD20 immunochemotherapy (rituximab-CHOP and rituximab-VCAP combinations) and at 12 months follow-up, she is in complete remission. DISCUSSION: The diagnosis of primary and isolated NHML of the uterine body is based on a clinical and further examination and regular follow-up for several months. The treatment is not codified; surgery, poly-chemotherapy and radiotherapy are the different therapeutic modalities. Rituximab-CHOP immunochemotherapy is currently the reference treatment for primary malignant lymphomas of the uterine body particularly in young patients who wish to become pregnant. The prognosis depends mainly on two factors: age and Ann Arbor stage. CONCLUSION: Primary uterine lymphomas are rare tumors of unknown etiopathogeny and of non-specific clinical presentation, the role of the various treatments remains difficult to evaluate due to the small number of published cases.

Gonococcal Endocarditis: The Gift That Stops Giving! An Uncommon Presentation of a Common Disease.

INTRODUCTION: Gonorrhea is the 2nd most common sexually transmitted disease in the US with 800,000 cases of gonorrhea each year. Disseminated gonorrhea infection occurs in 0.5 percent - 3 percent of these patients and is more frequent in woman younger than 40 years of age. CASE: A 36 year old woman with a history of polysubstance abuse presented with 10 day history of feeling generally unwell. At presentation, vitals were remarkable for tachycardia and hypotension. Physical exam was remarkable for conjunctival pallor, bibasilar crackles, and tachycardia with grade III/VI systolic murmur loudest over the 2nd inter-costal space and loudest with expiration. No skin lesions were noted. Labs demonstrated leukocytosis (WBC 20,200 with 84 percent neutrophils);, anemia (Hb 6.7);, thrombocytosis (platelets 423 k/uL);, abnormal liver function tests (alkaline phosphatase 239 IU, AST 151 IU ALT 71 IU, albumin 2.5g/dL);, PT/INR 17.1/1.5. Troponin 0.42, BNP 823, D-dimer 619, and a urine drug screen that was positive for benzodiazepines, opiates, barbiturates, amphetamine, and THC. Hep panel and HIV were negative. Chest radiograph showed mild cardiomegaly and early interstitial edema. The patient was placed on broad spectrum antibiotics and given adequate fluid resuscitation and blood products. Blood cultures grew Neisseria gonorrhoeae. 2D ECHO showed a large pedunculated/mobile echo density adherent to the non-coronary and lefts cusps of the aortic valve. Proximal aortic root and aorto-mitral continuity were thickened, consistent with aortitis and/or abscess formation. Initial EKG on arrival showed junctional tachycardia which progressed into complete heart block. Cardiology was consulted and a pacemaker was placed emergently. However despite all aggressive measures the patient died of cardiac complications. DISCUSSION: Endocarditis is a rare complication of disseminated gonorrhea, occurring in only 1-2 percent of patients with gonoccocemia. The aortic valve is most commonly affected. Valve replacement is warranted in cases with severe dysfunction. Mortality remains around 19-20. Neisseria gonorrhoeae endocarditis should be included in the differential diagnosis in sexually active patients with endocarditis.