[Furuncular myiasis: Case report of a cutaneous parasitosis usually considered as an abscess]. / La myiase furonculeuse: Cas clinique d'une parasitose cutanée souvent confondue avec un abcès.

Furuncular myiasis is a wel l established cutaneous parasitosis in tropical area. In Europe, most of cases have been described in patients returning from risk areas. We report a case of a 4-year old child with a furuncular lesion on his left thigh considered as an abscess and who was send to emergency department for surgical drainage.

La myiase furonculeuse est une parasitose cutanée bien connue dans les régions tropicales. En Europe, des cas rares ont été décrits chez des patients ayant séjourné dans les zones à risque. Nous rapportons le cas d'un enfant de 4 ans présentant un furoncle au niveau de la cuisse gauche considéré à tort comme un abcès et envoyé aux urgences pour drainage.

[Rational approach and management of the dyspnoeic patient in general medical practice]. / Approche rationnelle et prise en charge du patient dyspnéique en médecine génerale.

Dyspnea represents 3-4 % of consultations at primary care medicine (general medicine, emergency medicine) and is found in 14 % of the interviewed general population. It is defined as an abnormal and uncomfortable breathing and can be classified according to the mode of appearance, the breathing pattern or the rhythm. Different classifications are used to specify the severity of the situation: visual analog scale, functional classification of the New York Heart Association, dyspnea modified scale from the Medical Research Council, ... Rare among young people, dyspnea often hides asthma; more prevalent among seniors, it is often secondary to chronic lung or heart disease. The rational approach is the same in general medicine and in the emergency room. The management starts with an assessment of the severity of the patient's clinical situation, via the early warning score. The critical patient requires to be managed according to the progressive and cyclical ABCDE approach. For non-critical patients, a traditional approach and a reasoned method are needed. In patients suffering from chronic obstructive pulmonary disease (COPD), the use of the Anthonissen criteria allows to orient toward a pulmonary superinfection or another cause of worsening dyspnea (cardiac, ...). In case of suspected pulmonary embolism, the Geneva score and the modified Wells score help to separate low, intermediate or high probability cases of pulmonary embolism. D-dimers have a very good negative predictive value in the low and middle risk group and pulmonary CT angiography applies only to a smaller group of dyspnoeic patients with a high probability of pulmonary embolism. Echocardiography has a prominent role to assess the LV systolic function, the search for pulmonary artery hypertension, the vascular filling state, etc. We speak of psychogenic dyspnea after having excluded the potentially serious pathologies.