[Cholera in Brest, France]. / Le choléra en France, à Brest ?

This is a case report about a 54-year-old man with hypovolemic shock, due to diarrhea and major vomiting after his return from India. The isolation of Vibrio cholerae serogroup O1 (Ogawa serotype) explains this typical clinical presentation of cholera, seen in 10% of cholera cases only. The patient had co-infection with Vibrio cholerae and Campylobacter coli. Co-infections appear to be frequent in endemic areas. The purpose of this case report is to recall the relevance of Vibrio isolation when the clinical context is evocative (diarrhea on travel return, raw sea food consumption).

[Evaluation of the effect of hemolysis, bilirubin, lipemy, glucosis and natrium on mean concentration of hemoglobin (XN 2000® Sysmex®)]. / Évaluation de l'influence de l'hémolyse, de l'ictère, de la lipémie, d'un apport en glucose ou en sodium sur la concentration corpusculaire moyenne en hémoglobine (XN 2000® Sysmex®).

We evaluated the effect of haemolysis, bilirubin, lipemia, hyperglycemia and natremia on mean corpuscular haemoglobin concentration (MCHC) measured by XN 2000® (Sysmex®). Our evaluation had shown than correction is necessary for haemolysis and lipemia but not for icterus. There were not possible to reproduce variation of MCHC with hyperglycemia or variation of natremia. Blood smears show red blood cells abnormalities.

Streptococcus pneumoniae urinary tract infection in pedeatrics.

Streptococcus pneumoniae infections in children are most often lung infections or meningitis. Urinary tract infections are much rarer. We present the case of a urinary tract infection with Streptococcus pneumoniae. The clinical picture was classical. The urine culture showed the presence of Streptococcus pneumoniae in urine (104 UFC/mL; with 2 × 104 leucocytes/mL). The literature mentions a few cases of such infections. In some studies, the prevalence of Streptococcus pneumoniae in urine of children is less than 1%. Those children mostly present abnormalities of urinary tract. In our case, urinary ultrasound scan have shown the presence of an ectopic kidney in this child. The discussion between the clinician and the biologist has contributed to the discovery of this renal anomaly.

Self-induced drug intoxication in baclofen: of the calm hypotonic coma in the status epilepticus.

Baclofen is an agonist of peripheral and central B gamma-aminobutyric acid receptors, whose activation causes a myorelaxation and a powerfull depression of the central nervous system. Moreover, it has an action against addiction, in reducing craving. Commercialized since 1975 in France, to control muscle spasticity due to medullar affection or multiple sclerosis, it receives a temporary recommendation of use in march 2014, as a last-line adjuvant treatment in alcohol withdrawal. Beyond its therapeutic use, baclofen is involved in many self-induced intoxications. We report the case of a patient who develops, after a massive ingestion of baclofen (supposed dose ingested: 1 200 mg), a hypotonic and calm coma, requiring her admission in our intensive care unit, and then a status epilepticus.

[Acute arsenic poisoning]. / Intoxication aiguë à l'arsenic.

Acute arsenic poisoning is a rare cause of suicide attempt. It causes a multiple organs failure caused by cardiogenic shock. We report the case of a patient admitted twelve hours after an ingestion of trioxide arsenic having survived thanks to a premature treatment.