[Multi-resistant tuberculosis at the hôpital d'instruction des armées de Libreville (Gabon) about 16 cases].

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%.

Factors associated with negative direct sputum examination in Asian and African HIV-infected patients with tuberculosis (ANRS 1260).

Objective: To identify factors associated with negative direct sputum examination among African and Cambodian patients co-infected by Mycobacterium tuberculosis and HIV.

Design: Prospective multicenter study (ANRS1260) conducted in Cambodia, Senegal and Central African Republic.

Methods: Univariate and multivariate analyses (logistic regression) were used to identify clinical and radiological features associated with negative direct sputum examination in HIV-infected patients with positive M.

[Aetiology of AFB negative pneumonias in hospitalized HIV patients in Dakar].

A prospective study was carried out in two tertiary hospitals in Dakar to determine the main causes of sputum acid-fast bacillus (AFB) smear-negative pneumonia in HIV-infected patients. All clinical and microbiological records were reviewed by experts. Seventy patients were finally enrolled.

[Pleuro-pulmonary manifestations disclosing hepatic amoebiasis].

During a mission in ex-Yugoslavia between 2001 and 2004, three French soldiers were sent home because of right pneumopathy, right pleurisy after appendicectomy, haemoptysis and liver haematoma, respectively. They previously were stationed in Africa and/or South America. The initial diagnosis was quickly modified: pleuropulmonary manifestations of amoebic hepatic abscess in two cases, and pleuropulmonary amoebiasis in the last case.

Predictors of pneumocystosis or tuberculosis in HIV-infected Asian patients with AFB smear-negative sputum pneumonia.

Objectives: To identify predictors of Pneumocystis jiroveci pneumonia (PCP) or pulmonary tuberculosis (TB) in acid-fast bacillus smear-negative HIV-infected patients and to develop clinical prediction rules.

Design: A cohort study conducted in consecutive hospitalized Asian patients.

Methods: Multivariate analyses were performed on the Cambodian sample to determine clinical, radiological, and biological predictors of PCP or TB at hospital admission.

Clinical features and etiology of pneumonia in acid-fast bacillus sputum smear-negative HIV-infected patients hospitalized in Asia and Africa.

Objectives: To determine the main causes of acid-fast bacillus sputum smear-negative pneumonia in Asian and African HIV-infected patients

Design And Setting: A prospective multicenter study (ANRS 1260) of consecutive hospitalized patients in tertiary hospitals in Phnom Penh, Ho Chi Minh City, Bangui and Dakar.

Intervention: Use of the same clinical, radiological and biological methods at the four sites; regular quality controls of participating laboratories; final review of medical records by experts. Similar criteria used to establish diagnoses.

[Lung cancer in Senegal].

In Africa the incidence of lung cancer is rising rapidly. The purpose of this prospective study was to analyze clinical, therapeutic, and prognostic features of lung cancer patients treated at the Principal Hospital in Dakar between 2002 and 2007. A total of 72 cases were compiled over the 5-year study period.

[Spontaneous regression of hepatic and splenic involvements during sarcoidosis].

Splenic and hepatic involvements are frequent and usually clinically silent during systemic sarcoidosis. Imaging findings are extremely rare. We report hepatic and splenic nodules diagnosed on abdominal computed tomography with spontaneous regression.

[The problem of oxygen in developing countries].

Availability of a reliable oxygen (O2) supply is critical for hospitals in developing countries. The AIDS pandemic that is associated with severe pulmonary infections has further enhanced this problem. Today in 2006, even though a number of financially viable solutions adapted to conditions in developing countries are available, lack of oxygen is still a cause of death in Africa including in some capital cities.

[Pseudotumoral presentation of American pulmonary histioplasmosis].

In France, American pulmonary histoplasmosis is an imported deep mycosis, caused by inhalation of Histoplasma capsulatum. Clinical and radiological features of this exotic disease are multiple, simulating tuberculosis or cancer. We report two cases of American histoplasmosis with pseudo-tumoral form, in immunocompetent subjects working in Venezuela, with a multinodular pulmonary presentation.

[Respiratory dysfunction in burned patients].

Introduction: Smoke inhalation and respiratory complications are still the major causes of mortality in severely burned patients.

State Of The Art: The diagnosis is suspected clinically on the basis of history and physical examination and can be confirmed bronchoscopically. Respiratory failure in burned patients occurs through a number of associated mechanisms.

[18-FDG positon emission tomography and distal metastasis from lung cancer].

"Whole body" FDG-PET usually covers the body from the base of the skull to the upper third of the thighs, arms in abduction. Thus, the upper part of the head and the lower limbs are not included in the acquisition field. We report the cases of three patients with non-small-cell lung cancer who developed secondary distal localizations beyond the acquisition field of "whole body" FDG-PET.

[The risk of thromboembolism in airline passengers].

Long carrier flights favor thromboembolism. The risk is well known to the general public but is probably really very low. The risk is however pertinent due to the volume of air travel in the world.

[An unusual cause of acute respiratory distress: obstructive bronchial aspergillosis].

We report the case of a 77-Year-old immunocompetent woman who required intensive care for acute dyspnea revealing complete atelectasia of the left lung related to an aspergillus mycelium plug blocking the principal bronchus. The clinical course was favorable after deobstruction by thermocoagulation and oral itraconazole given for six Months. The patient was free of parenchymatous or endobronchial sequelae.

[Laryngeal disorder revealing unrecognized pulmonary tuberculosis].

Laryngeal tuberculosis is exceptional and identification in this localization can reveal clinically unrecognized pulmonary tuberculosis. We report two cases illustrating this situation. The pseudo-tumor aspect observed at endoscopy may be wrongly suggestive of neoplasia.

Bronchoscopy with the Vision Sciences BF100 disposable-sheath device: French experience after 328 procedures.

Background: In spite of adhesion to recommended disinfection procedures, the transmission of infections by bronchoscopes is a permanent problem.

Objective: The new device may prevent nosocomial infections because it consists of two parts: a specific bronchoscope Vision Sciences BF100 and a single-use protective sheath for each procedure. The aim of this paper is to report our practice and the difficulties encountered when using this system.

[Complications of implantable sites].

Approximately 50,000 implantable sites are prepared each year in France because of the undeniable advantage for the treatment of patients requiring long-duration intravenous infusions. The benefits of this technique must not overshadow the mechanical risks inherent in their installation and complications related to their use: infections, thromboembolic events. Clear, precise, and adapted treatment protocols must be established and rigorously implemented by the healthcare team.

[Thoracic nocardiasis associated with macrophage activation syndrome].

Nocardiasis is an uncommon bacterial disease often observed in immunodepressed patients. Its interactions with the immune system remain poorly known. We report a case of Nocardia asteroides thoracic nocaridiasis in an African subject who also had macrophage activation syndrome.