[Two case reports of meningococcemia. Review of the literature on chronic meningococcemia]. / À propos de deux cas de méningococcémie. Revue de la littérature sur la méningococcémie chronique.

INTRODUCTION: Neisseria meningitidis is a Gram-negative bacteria that can be highly pathogenic in humans and responsible for life-threatening and acute diseases. In a few cases, it can lead to an atypical form of sepsis-acute, subacute, or chronic-which, even if progression is slower, may carry the same risks for patients as conventional acute forms. CASES: Case 1 presented with recurrent fever, polyarthralgia, and generalized macular rash. Case 2 had fever for the previous 10days with neck pain and macular rash. Blood cultures were positive for group B meningococcus in both cases. Polymerase chain reaction (PCR) analysis for the same pathogen was also positive in the cerebrospinal fluid (CSF) of Case 2. Following intravenous antibiotic treatment, the progression was favorable in both cases. DISCUSSION: Chronic meningococcemia is characterized by a triad of clinical features, including a fever lasting for at least 1week, arthralgia, and a cutaneous rash. This condition evolves positively without any sequelae if treated properly. PCR and blood culture are two complimentary tools that support the diagnosis. CONCLUSION: Meningococcal infection can manifest in a variety of ways. Chronic meningococcemia diagnosis should be considered in a triad of prolonged fever, rash, and arthralgia. Better access to state-of-the-art techniques such as PCR is recommended in the future so as to provide optimal care of patients suffering from this condition.

A nephrotic syndrome of tropical origin: case report and short review of the aetiology.

We present a case of nephrotic syndrome in a 38-year-old man of Ivorian origin. In the search of the cause of his illness an infection with Plasmodium malariae (P. malariae) was diagnosed by serology and by microscopy of a Giemsa thin blood smear which revealed rare gametocytes of P. malariae. Proteinuria significantly diminished within three months after antimalarial treatment. Antibodies against Schistosoma were detected as well. Examination of kidney biopsy revealed a discrete mesangioproliferative glomerulonephritis. This case highlights that a thorough history-taking may be essential and that infectious diseases should be included in the differential diagnostic thinking process when a nephrotic syndrome is diagnosed.

[Comparison of three selective chromogenic media for Methicillin-Resistant Staphylococcus aureus detection]. / Comparaison de trois milieux sélectifs chromogènes pour la détection de Staphylococcus aureus résistant à la méthicilline.

PURPOSE: Rapid detection of Methicillin-Resistant Staphylococcus aureus (MRSA) is of major importance in hospital hygiene. In order to reduce the response time from screening laboratories, new selective chromogenic media have been developed and marketed by major microbiology companies. In this context, an evaluation of their performances was needed. MATERIALS AND METHODS: Media produced by Bio-Rad Laboratories (MRSASelect), Becton Dickinson (CHROMagar MRSA) and bioMérieux (chromID MRSA) were studied by 203screening samples, 110 of which were MRSA positive. Each Stahylococcus aureus was identified by catalase detection, Staphytect Plus Dryspot latex agglutination test and free coagulase detection, in addition to mannitol fermentation and Voges-Proskauer tests in the case of doubtful identification. Resistance was verified by checking the inhibition zone diameter of under 20 mm on 30 microg cefoxitin disks. RESULTS: Bio-Rad Laboratories, Becton Dickinson and bioMérieux media read at 24 or 24/48 hours have a respective sensitivity of 91, 71 and 85/92%. The specificity of these media is 99, 100 and 99/93%. CONCLUSION: These media proved to be new powerful and rapid tools used in screening for MRSA detection. MRSASelect is one of the most effective media showing high sensitivity and specificity and the easiest interpretation. chromID MRSA exhibits similar performance but needs more time to be as effective as Bio-Rad media while CHROMagar MRSA isn't enough efficient with its slightly lack of sensitivity to perform a reliable screening.

Pasteurella multocida in peritoneal dialysis: a rare cause of peritonitis associated with exposure to domestic cats.

Pasteurella multocida is a rare cause of peritonitis in peritoneal dialysis patients with only 10 cases reported in the literature so far. All cases were observed in patients with close contact with cats, usually with a direct puncture of the dialysis tubing. We report a case of Pasteurella multocida peritonitis in a patient maintained under continuous cycling peritoneal dialysis (CCPD), who had frequent and close contact with cats. Patients should be made aware of this potential complication and advised to keep domestic animals away from the location of their peritoneal exchanges.