Hiatal hernia by rolling is a rare pathology estimated at 5% of all diaphragmatic hernias. It is usually asymptomatic. Sometimes, it can be accompanied by different symptoms, such as post prandial bloating, dysphagia,...Hiatal hernia by rolling is a rare pathology estimated at 5% of all diaphragmatic hernias. It is usually asymptomatic. Sometimes, it can be accompanied by different symptoms, such as post prandial bloating, dysphagia, regurgitation, retro sternal pain, even respiratory symptoms. The aim of this article is to show that a hiatus hernia by rolling can cause a misleading clinical picture that may be taken wrongly for a heart or respiratory disease. We report the case of an 80-year-old patient whose presentation was suggestive of an acute heart condition, but the scan confirmed a rolling diaphragmatic hernia. Because of the rarity and the atypical presentation of this case, we have found it desirable to bring this new observation.展开更多
Ataxia Telangiectasia (AT) is a rare autosomal recessive multisystem disease. The diagnosis is often made on a clinical triad that combines neurological signs dominated by a progressive cerebellar ataxia, oculocutaneo...Ataxia Telangiectasia (AT) is a rare autosomal recessive multisystem disease. The diagnosis is often made on a clinical triad that combines neurological signs dominated by a progressive cerebellar ataxia, oculocutaneous signs (telangiectasia, coffee stain milk), immunodeficiency (humoral and cellular) with sinopulmonary infections and elevated alphaphetoprotein. The diagnosis of AT is usually early, however, some forms may be revealed late. We reported a case of a 19-year-old patient, admitted for severe pneumonia with Klebsiella Pneumonia. In its history, it was found a notion of recurrent respiratory infections and bronchiectasis. In its clinical examination, it had been discovered cerebellar ataxia and occulocutaneous telangiectasia. The determination of plasmatic alphafoetoprotein was elevated, and the search of immunodeficiency showed a mixed deficit (humoral and cellular) suggesting the diagnosis of AT.展开更多
Gemella morbillorum (G. morbillorum) is an opportunistic bacterium, which can sometimes cause severe infections especially in immunocompromised subjects. Respiratory infections due to this germ are rare, but are descr...Gemella morbillorum (G. morbillorum) is an opportunistic bacterium, which can sometimes cause severe infections especially in immunocompromised subjects. Respiratory infections due to this germ are rare, but are described. We reported a new observation of 34-year-old female patient, admitted for unusual location and clinical presentation of respiratory infection with G. morbillorum;she was presented a left pleuritic pain, a productive cough associated with purulent and foul sputum and dyspnea with onset one month earlier. The clinical examination was objectified a polypnea at 32 cycles/minutes, intercostal indrawing and mixed pleural effusion syndrome. She had also many dental caries and bad oral health status. Chest radiography showed an air-fluid image in the left chest and the thoracocentesis had revealed purulent fluid. The culture of this fluid had isolated a G. morbillorum. The diagnosis of mixed pleural effusion due to G. morbillorum in an immunosuppressed diabetic patient was made. The patient was put on antibiotics, thoracic drainage and Chest physiotherapy with good improvement.展开更多
Introduction: The pneumocystosis is an infection caused by a saprophytic germ Pneumocystis jiroveci. It is exceptional in immunocompetent patients. Case report: This is a 30-year-old patient, admitted to the service f...Introduction: The pneumocystosis is an infection caused by a saprophytic germ Pneumocystis jiroveci. It is exceptional in immunocompetent patients. Case report: This is a 30-year-old patient, admitted to the service for an acute respiratory failure. She was treated for pulmonary tuberculosis 6 months ago. The review has objectified clinique cyanosis of the lips and extremities with a blood pressure 120/70 mmHg, a heart rate of 70 bats/min, a temperature of 38°C and SaO2 to 82% in the open air. The chest radiograph objectified reticulonodular opacities on the right. The patient was put under bi-broad-spectrum antibiotics. Due to the non improvement of the patient’s state, the search for Pneumocystis jiroveci in induced sputum was made and it was positive. The search for a field of immunosuppression was negative.展开更多
文摘Hiatal hernia by rolling is a rare pathology estimated at 5% of all diaphragmatic hernias. It is usually asymptomatic. Sometimes, it can be accompanied by different symptoms, such as post prandial bloating, dysphagia, regurgitation, retro sternal pain, even respiratory symptoms. The aim of this article is to show that a hiatus hernia by rolling can cause a misleading clinical picture that may be taken wrongly for a heart or respiratory disease. We report the case of an 80-year-old patient whose presentation was suggestive of an acute heart condition, but the scan confirmed a rolling diaphragmatic hernia. Because of the rarity and the atypical presentation of this case, we have found it desirable to bring this new observation.
文摘Ataxia Telangiectasia (AT) is a rare autosomal recessive multisystem disease. The diagnosis is often made on a clinical triad that combines neurological signs dominated by a progressive cerebellar ataxia, oculocutaneous signs (telangiectasia, coffee stain milk), immunodeficiency (humoral and cellular) with sinopulmonary infections and elevated alphaphetoprotein. The diagnosis of AT is usually early, however, some forms may be revealed late. We reported a case of a 19-year-old patient, admitted for severe pneumonia with Klebsiella Pneumonia. In its history, it was found a notion of recurrent respiratory infections and bronchiectasis. In its clinical examination, it had been discovered cerebellar ataxia and occulocutaneous telangiectasia. The determination of plasmatic alphafoetoprotein was elevated, and the search of immunodeficiency showed a mixed deficit (humoral and cellular) suggesting the diagnosis of AT.
文摘Gemella morbillorum (G. morbillorum) is an opportunistic bacterium, which can sometimes cause severe infections especially in immunocompromised subjects. Respiratory infections due to this germ are rare, but are described. We reported a new observation of 34-year-old female patient, admitted for unusual location and clinical presentation of respiratory infection with G. morbillorum;she was presented a left pleuritic pain, a productive cough associated with purulent and foul sputum and dyspnea with onset one month earlier. The clinical examination was objectified a polypnea at 32 cycles/minutes, intercostal indrawing and mixed pleural effusion syndrome. She had also many dental caries and bad oral health status. Chest radiography showed an air-fluid image in the left chest and the thoracocentesis had revealed purulent fluid. The culture of this fluid had isolated a G. morbillorum. The diagnosis of mixed pleural effusion due to G. morbillorum in an immunosuppressed diabetic patient was made. The patient was put on antibiotics, thoracic drainage and Chest physiotherapy with good improvement.
文摘Introduction: The pneumocystosis is an infection caused by a saprophytic germ Pneumocystis jiroveci. It is exceptional in immunocompetent patients. Case report: This is a 30-year-old patient, admitted to the service for an acute respiratory failure. She was treated for pulmonary tuberculosis 6 months ago. The review has objectified clinique cyanosis of the lips and extremities with a blood pressure 120/70 mmHg, a heart rate of 70 bats/min, a temperature of 38°C and SaO2 to 82% in the open air. The chest radiograph objectified reticulonodular opacities on the right. The patient was put under bi-broad-spectrum antibiotics. Due to the non improvement of the patient’s state, the search for Pneumocystis jiroveci in induced sputum was made and it was positive. The search for a field of immunosuppression was negative.
