[Purulent pericarditis, an unusual complication of pneumococcal pneumonia: a case report]. / Péricardite purulente Complication inhabituelle de pneumonie à pneumocoque : à propos d'un cas chez une femme enceinte.

Purulent pericarditis has become rare since the advent of antibiotics. Among the involved germs, S. pneumoniae remains the most implicated pathogen to evoke in principle, especially that prescription of systematic antibiotics for any febrile condition can considerably mask the clinical picture. A 36-year-old pregnant woman was visiting the emergency department for dyspnea and flu-like syndrom that had been going on for a week. The chest X-ray showed a white lung on the left and the transthoracic ultrasound revealed a pericardial effusion, resulting in pericardial drainage and pleural puncture that allows the evacuation of a purulent fluid. S. pneumoniae was identified on the pericardial fluid. Antibiotic therapy and resuscitation measures have allowed a good evolution. Even if it has become exceptional, pneumococcal pericarditis must not be overlooked since the evolution is often favorable in triple conditions: early recognition, prompt institution of appropriate antibiotic therapy, and early surgical drainage.

[Fahr syndrome secondary to primary hypoparathyroidism: about a case]. / Syndrome de Fahr secondaire à une hypoparathyroïdie primaire: à propos d'un cas.

Fahr syndrome is a rare anatomo-clinic disease whose most common cause is primary or postoperative hypoparathyroidism. It is characterized by bilateral and symmetrical intracerebral calcifications located in the central gray nuclei, most often associated with phosphocalcium metabolism disorders. We here report the case of a 54-year old patient who had been treated for primary hypoparathyroidism for 20 years, presenting with amnesic disorders revealing Fahr syndrome secondary to hypoparathyroidism.

[Disseminated intravascular coagulation: clinical and biological diagnosis]. / La coagulation intravasculaire disséminée : diagnostic clinique et biologique.

Disseminated intravascular coagulation (DIC) is a syndrome characterized by the systemic activation of blood coagulation. Its pathophysiological mechanisms are complex and dependent on the underlying pathology, making the clinical and biological expression of quite variable DIC. Among the various biological parameters disrupted, most are not specific, and none of them allows in itself to make the diagnosis. All this does not facilitate the task of the practitioner for diagnosis of overt DIC, much less that of the non-overt DIC, early stage whose treatment would improve the prognosis. These considerations have led to develop scores, combining several parameters depending on their availability in daily practice, as well as their diagnostic relevance. Of all the scores, the ISTH (International society of thrombosis and hemostasis) remains the most used.