[Multi-resistant tuberculosis at the hôpital d'instruction des armées de Libreville (Gabon) about 16 cases]. / Tuberculose multirésistante à l'hôpital d'instruction des armées de Libreville (Gabon) à propos de 16 cas.

According to WHO estimates, between 1 and 20% of tuberculosis cases in the world are multiresistant. In Gabon, this prevalence is estimated at 1.9%. In this forward-looking study from March 2006 to August 2010, we report 16 cases of multi-resistant tuberculosis out of 24 suspected resistant samples (persistence of the clinical and radiological signs after three months of well conducted treatment with first-line anti-tuberculous drugs). This study is realized in association with the laboratory of mycobacterium of the Percy military teaching hospital, Clamart, France.

[Hematological disorders and hypereosinophilias]. / Hyperéosinophilies et affections hématologiques.

Hematological disorders are the third cause of hypereosinophilia, after allergic and parasitic diseases. Hematological disorders associated with hypereosinophilias can be classified as clonal, reactive or idiopathic, and recently the improvements of cytogenetic, molecular biology and immunology have allowed to revisit numerous cases previously diagnosed as idiopathic hypereosinophilic syndrome. Reactive eosinophilias are mainly associated with lymphoma or abnormal, often clonal T lymphoid population. Clonal eosinophilia is related either to various myeloid malignancies or to a genuine myeloproliferative disorder from the eosinophile lineage, the so-called chronic eosinophilic leukaemia. Chronic eosinophilic leukaemia can be associated with recurrent genes rearrangements involving PDGFRA, PDGFRB and FGFR1 or with clonal abnormalities not yet categorized. Idiopathic hypereosinophilic syndrome remains an exclusive diagnosis in presence of moderate or severe unexplained eosinophilia with target organ damage. The purpose of the diagnostic work-up of hypereosinophilic syndrome is to evidence either an abnormal T cell population or a clonal haematopoiesis. Imatinib mesylate dramatically improves chronic eosinophilic leukaemias associated with PDGFR abnormalities, while corticosteroids are still the main treatment for the other patients. In a near future, advances could arise from identification of new genes involved in clonal eosinophilia or in alternative therapy such as the anti-IL-5 antibodies.

[Mycoplasma pneumoniae encephalitis successfully treated by levofloxacin]. / Méningo-encéphalite aiguë à Mycoplasma pneumoniae de l'adulte traitée avec succès par lévofloxacine.

INTRODUCTION: Mycoplasma pneumonia (MP) infection may be associated with several neurological complications. Encephalitis, which affects children and rarely young adults, is the most frequent. CASE REPORT: A 23-year-old man was admitted for pneumonia with encephalitis. Mycoplasma pneumoniae infection was documented by serology, and polymerase chain reaction in the cerebrospinal fluid. Despite serious initial presentation, outcome was favourable with levofloxacin treatment. CONCLUSION: MP infection should be considered as a potential aetiology in acute encephalitis in young people and in individuals with respiratory symptoms. Antibiotic therapy (fluoroquinolones or macrolides) should be used if MP is strongly suspected or in case of severe acute meningo-encephalitis.

[Mycoplasma pneumoniae: a cause of febrile hemolytic anemia in travelers]. / Mycoplasma pneumoniae: une cause d'hémolyse fébrile chez le voyageur.

Mycoplasma pneumoniae can cause varied hematologic manifestations that are frequently associated with lower respiratory tract infections. Acute febrile hemolysis without respiratory symptoms is quite rare. We describe the case of a 25-year-old man, admitted for acute fever with hemolysis, after returning from Djibouti. M. pneumoniae infection was proved by serological testing. A favorable outcome followed macrolide treatment.

[Multifocal pyomyositis after being hit by a truncheon in Gabon]. / Pyomyosite multifocale après coups de matraque au Gabon.

Pyomyositis is an acute primary bacterial infection of striated muscle. It affects mainly but not only immunocompromised patients, especially in tropical areas. The responsible microbe is often found to be Staphylococcus aureus. We report here the case of an immunocompetent 17-year-old with multifocal pyomyositis from which S. aureus was isolated two weeks after he was hit with a truncheon.

[Pleuropulmonary manifestations of necrotising vasculitis]. / Manifestations pleuropulmonaires des vascularites nécrosantes.

The pleuropulmonary manifestations of necrotising vasculitis are frequent and polymorphic. If the existence of extrapulmonary signs and the presence of neutrophil polynuclear anticytoplasmic antibodies are helpful for the diagnosis of a bout of vasculitis, the existence of pleuropulmonary symptoms can also make for discussion of infections or iatrogenic effects induced by immunosuppressive treatments.