Spontaneous Pneumomediastinum Associated with COVID-19 Pneumonia.

The first case of coronavirus disease 2019 (COVID-19) was declared in December in Wuhan, before becoming a global pandemic in a few weeks. Several complications of this infection have been reported. However, a spontaneous pneumomediastinum has rarely been described. We report the fourth case of this extremely rare complication in a 65-year-old male patient with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pneumonia, discovered during his therapeutic management by a CT scan control.

[Cerebral thrombophlebitis: complication of frontotemporoparietal cellulitis in a child victim of human bite]. / Thrombophlébite cérébrale: complication d'une cellulite fronto-temporo pariétale chez un enfant victime d'une morsure humaine.

Cerebral thrombophlebitis is a rare but severe disease whose underestimated frequency is increasingly recognized among children and, unlike adults, management is controversial. We report the case of a 12-year old child bitten by a friend at the level of the scalp, in the frontotemporal region of the head. This bite evolved due to the occurrence of a swelling evoking a frontotemporoparietal cellulitis complicated by cerebral thrombophlebitis, diagnosed based on the clinical feature and imaging. The patient was admitted in our hospital in a state of conscience disorder. Anticoagulant and etiological treatments enabled good clinical evolution.

[Rupture of the descending thoracic aorta following sudden traumatic deceleration injury]. / Rupture de l'aorte thoracique descendante suite à une décélération brutale post traumatique.

Acute post-traumatic rupture of the thoracic aorta is the second cause of road traffic deaths; 80% of patients die at the scene of the accident. The involvement of its descending portion outside the isthmus is rare and it is estimated to be less than 3%. We report the case of a 60-year old man, victim of road traffic accidents (RTA) whose mechanism was: the motorcyclist was struck by a car; the points of impact included the right upper limb and the chest. This RTA caused a fracture in both bones of the forearm and a rupture of the descending thoracic aorta (ATD). Treatment was based in the first time on the suture of the aortic rupture complemented by synthetic circumferential prosthesis implantation with aorto-aortic anastomosis and in a second time on the application of a screwed plate in the forearm. The outcome was good and the patient was referred to the Department of vascular surgery.

[Leptospirosis revealed by acute pancreatitis]. / Leptospirose révélée par une pancréatite aiguë.

Leptospirosis is an ubiquitous anthropozoonosis particularly frequent in the tropical climate zone. It is caused by gram negative, strictly aerobic bacteria belonging to the order Spirochaetales and to the family Leptospira whose transmission usually occurs through contact with water sources contaminated with animal urine (carriers). Acute pancreatitis is a rare complication of leptospirosis; it is associated with high mortality rates. We report the case of a 66-year old patient in whom the diagnosis of leptospirosis was made after a rare complication of pancreatitis. Our patient was admitted with septic shock requiring hemodynamic and respiratory support with renal dialysis. The outcome was favorable.

[Miller Fischer syndrome: about a paediatric case]. / Le syndrome de Miller Fischer: à propos d'un cas pédiatrique.

Miller Fischer (MF) syndrome is a rare variant of Guillain-Barré syndrome which occurs only in 5% of cases among adults while the pediatric cases described in the literature are even more rare. We here report the case of a 12-year old boy who was diagnosed with Miller Fischer syndrome based on clinical presentation characterized by obvious ocular involvement and anti-ganglioside antibody-positivity. The patient was admitted to our hospital with respiratory distress requiring orotracheal intubation and intravenous immunoglobulins, with good clinical evolution.