[A rare infectious etiology of COPD exacerbation]. / Une étiologie infectieuse rare d'exacerbation de bronchopneumopathie chronique obstructive.

Chronic obstructive pulmonary disease (COPD) is a common respiratory disorder. Its exacerbation is infectious in more than half of the cases: with viral priority, while parasitic causes remain exceptional. In this work, we report a case of a COPD exacerbation caused by a visceral leishmaniasis (VL) complicated by a macrophage activation syndrome in an adult living in a Moroccan non-endemic region for this of leismaniasis form. In such atypical clinical feature, the diagnosis of VL was based on the myelogram after presence of peripheral cytopenia. Despite the seriousness of these pathologies, the early and specific treatment of VL allows a quickly improvement in the disorders caused by these diseases.

[Sarcoïdose in patient with chronic hepatitis C treated with pegylated interferon]. / Sarcoïdose chez un patient traité par interféron pégylé pour une hépatite chronique C.

Induced sarcoïdosis during therapy with interferon for chronic viral hepatitis C involves mainly by isolated cutaneous lesions or with lung lesions. Systemic forms are very rare. We report an observation. A 50-year-old patient developed a systemic sarcoïdosis two months after the end of treatment for hepatitis C with pegylated interferon and ribavirin with lung, joint and hepatic manifestations. After starting corticosteroid therapy, the evolution was favourable. Induced sarcoïdosis by interferon therapy is rare, treatment necessitates stopping interferon, and sometimes corticosteroid therapy.

[Hemoptysis revealing an endobronchial metastasis of testicular choriocarcinoma]. / Hémoptysie révélant une métastase endobronchique d'un choriocarcinome testiculaire.

The choriocarcinoma are neoplasms developed from testicular germ cells in men or fetal trophoblasts in women. The most common sites for metastatis are in the lung, but the endobronchial location is unusual. We report the case of a young patient of 27 years, hospitalized for hemoptysis of moderate volume, occurring in the context of deterioration in his general condition. The radiological assessment revealed an opacity of the right lung and bronchoscopy showed a highly vascularized middle lobe stenosis with biopsy confirming the diagnosis of choriocarcinoma. Urogenital examination found an enlarged left testicle and ultrasound confirmed a tumor-like expansive process with no liver or spleen involvement. HCG levels were high. The patient underwent a left orchiectomy via inguinal, pathological and immunohistochemical study confirmed the diagnosis of testicular choriocarcinoma. The patient received three cycles of chemotherapy based on the BEP with good tolerability. This has allowed chemotherapy, despite endobronchial metastasis, to achieve remission of good quality. The frequency of atypical choriocarcinoma metastases is very low, and treatment is mainly based on chemotherapy.

[Adrenal tuberculosis: case report]. / La tuberculose surrénalienne : à propos d'un cas.

Isolated adrenal tuberculosis is rare, and represents between 1-2% of the etiologies of adrenal masses called incidentalomas. A 32-year-old woman, without notable medical history, was hospitalized for pain in the left hypochondrium, lasting for two months in a context of apyrexia and weight loss amounted to 5 kg. Clinical examination was normal, but abdominopelvic CT objectified bilateral adrenal hypertrophy predominantly left with bilateral linear calcifications. The chest radiograph was normal, adrenal hormones were normal. The research of BK in sputum and urine were negative on direct examination and culture. The tuberculin was 12 mm and HIV status was negative. A left adrenal biopsy was done and histopathological study of tuberculous lesions was found confirming caseofolliculaire adrenal tuberculosis. The patient has been treated with antibacillaire with favorable evolution. In light of this observation, the authors make the point on this rare disease.

[Chronic alveolar syndrome]. / Syndrome de condensation alvéolaire chronique.

We report a case of primary pulmonary Hodgkin's disease in a 20 year-old woman. The chest x-ray showed a chronic alveolar syndrome. The diagnosis was established from a pulmonary biopsy. The radiological features and the options for diagnosis of primary pulmonary Hodgkin's disease are discussed.

[A rare cause of posterior mediastinal tumors: extramedullary hematopoiesis]. / Une cause rare des tumeurs du médiastin postérieur: l'hématopoïèse extra-médullaire.

We report a case of a patient with intrathoracic extramedullary hematopoiesis presenting as a posterior mediastinal tumor, without associated myelofibrosis. Pathophysiology and the options for diagnosis and treatment in this condition are discussed.

[Multifocal tuberculosis: fatal outcome due to toxic drug reactions]. / La tuberculose multifocale.

We report a case of multifocal tuberculosis with the following features: - skin involvement with multiple gommes disseminated on the left upper limb, the left flank, the right hypocondrium, and the right leg; - nodal involvement including the left supraclavicular, left axillary, right laterotracheal, pre and subcarineal, ceoeliomesenteric, and liver hilus nodes; splenic involvement; right pleural involvement; - spondylodiscitis of T11-T12 and of the head of the right fibula; - peritoneal involvement leading to ascitis; - multi-organ involvement. This 43-year-old woman had not particular history: no diabetes, no renal failure, no long-term corticosteroid treatment, no immunosuppressor treatment, negative HIV-1 and HIV-2 serology. Treatment with anti-tuberculosis agents led to severe drug reactions causing death due to hepatic encephalitis.