[Limp with fever in adolescent: about 2 cases of pyomyositis].

The authors report on 2 cases of limp with fever in adolescents, which developed after vigorous physical activity and were due to pyomyositis. Clinical, biological and radiological findings of the disorder are reviewed. Treatment is discussed.

[Intraventricular schwannoma: a case report].

Ventricular schwannomas are very uncommon. We report such a tumor in the right lateral ventricle of a 16-year-old young man. The various etiopathogenic hypotheses are discussed.

In vitro activity of temocillin against prevalent extended-spectrum beta-lactamases producing Enterobacteriaceae from Belgian intensive care units.

Temocillin is a narrow spectrum penicillin with high stability to most beta-lactamases including AmpC types and extended-spectrum types (ESBLs). We have analysed its in vitro activity against 652 clinical isolates of Enterobacteriaceae prospectively collected from patients hospitalised in intensive care units at seven different university hospitals in Belgium in 2005. Strains were screened for ESBL production using cefotaxime and ceftazidime screen agar plates and by double ESBL E-tests.

Primary cardiac lymphoma and complete atrio-ventricular block: case report and review of the literature.

Primary cardiac lymphoma (PCL) is a rare and extremely aggressive malignancy, which can express itself by damaging the cardiac conduction system (complete atrio-ventricular block), the myocardium and the pericardium. Histology confirms the diagnosis. Chances of survival depend on early diagnosis and treatment.

Emergence of ArmA and RmtB aminoglycoside resistance 16S rRNA methylases in Belgium.

Objectives: 16S rRNA methylase-mediated high-level resistance to aminoglycosides has been reported recently in clinical isolates of Gram-negative bacilli only from a limited number of countries. This study was conducted to investigate the occurrence of this type of resistance in clinical isolates of Enterobacteriaceae from two Belgian hospitals and the characteristics of the strains.

Methods: We screened for high-level gentamicin, tobramycin and amikacin resistance in clinical isolates of Enterobacteriaceae consecutively collected between 2000 and 2005 at two laboratories by PCR for the armA, rmtA and rmtB 16S rRNA methylase genes.

Evaluation of a new selective chromogenic agar medium for detection of extended-spectrum beta-lactamase-producing Enterobacteriaceae.

A novel chromogenic agar medium (ESBL-Bx; bioMérieux, Marcy l'Etoile, France) was compared to MacConkey agar supplemented with 2 mg ceftazidime/liter (MCKC) for the selective isolation and presumptive identification of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae directly from clinical samples. Of a total of 644 clinical specimens (including 551 fecal samples), 496 yielded no growth and 148 yielded growth on one or both media. Overall, 44 ESBL-producing Enterobacteriaceae strains (Escherichia coli [n=17], Enterobacter aerogenes [n=17], Klebsiella spp.

Guidelines for the management of epilepsy in the elderly.

Seizures starting in patients over 60 years old are frequent. Diagnosis is sometimes difficult and frequently under- or overrated. Cerebrovascular disorders are the main cause of a first seizure.

Prevalence and mechanisms of resistance to fluoroquinolones in Helicobacter pylori strains from patients living in Belgium.

Background: Because of the increasing resistance of Helicobacter pylori against metronidazole and clarithromycin, alternative regimens including newer fluoroquinolones have been developed. We aimed to assess the prevalence as well as the mechanisms of this resistance in clinical isolates originating from patients living in Belgium.

Methods: Minimal inhibitory concentration (MIC) values of ciprofloxacin, levofloxacin, and moxifloxacin were determined by Etest method on 488 H.

Outbreak of infection by carbapenem-resistant Acinetobacter baumannii producing the carbapenemase OXA-58 in Belgium.

Carbapenem-resistant Acinetobacter baumannii isolates were obtained from 17 patients between September 2004 and August 2005 at the Academisch Ziekenhuis Vrije Universiteit Brussel, Brussels, Belgium. These multidrug-resistant isolates, which belonged to a single clone, remained susceptible to colistin and tigecycline only and produced the carbapenem-hydrolyzing oxacillinase OXA-58. This study highlights the importance of the intercountry spread of this beta-lactamase-mediated resistance mechanism and its epidemic evolution.

Atopic myelitis: a clinical, biological, radiological and histopathological diagnosis.

We describe a young patient with an unusual intramedullary lesion filled with eosinophils. The 21-year-old man developed chronic myelitis without optic neuritis or signs of systemic or infectious disease. A spinal biopsy was conducted because of the progressive extension and pseudo-tumoural aspect of the lesion.

Guidelines to the management of epistaxis.

This article is a review of the literature on epistaxis and its treatment. Data were collected from MedLine until mid September 2005, and from others readings and books. Its first goal was to present to the Belgian ENT practitioners an overview, as complete as possible, of the modern concepts in etiologies, medical, conservative, surgical (including embolization), and adjunctive therapies of epistaxis.

[Unfavorable influence of the dynamic neutralization system on sagittal balance of the spine].

Purpose Of The Study: The dynamic neutralization system (Dynesis) has been proposed for the treatment of symptomatic lumbar discopathy. This system preserves the mobility of the instrumented vertebral segment and restores discal height by posterior distraction on pedicular screws, stabilization being ensured by compression on a spacer. The potential kyphosing effect of this system and the impact on sagittal morphology of the spine were analyzed.

Staphyloccocal scalded skin syndrome in an adult.

We report a case of staphyloccocal scalded skin syndrome due to an oxacillin-susceptible Staphylococcus aureus in an 81-year-old woman. The patient was admitted to the emergency room with arthritis of the left shoulder, ten days after an intra-articular injection of corticosteroids. The shoulder's puncture showed a purulent liquid and gram positive cocci in cluster suggesting the presence of Staphylococcus sp.

[A-leukemic caecal myeloid sarcoma: a difficult diagnosis].

Myeloid sarcoma is a malignant neoplasia composed of abnormal myeloid or monocytic cells, often localized in bones, but also rarely in extra-medullary sites such as lymph nodes, skin and soft tissue. We report a case of caecal myeloid sarcoma, diagnosed in a 60 year old woman who complained from abdominal pain and weight loss, in absence of any medullary disorder. Initially misdiagnosed as a B lymphoma because of a weak positivity for CD79a, the diagnosis of primitive caecal myeloid sarcoma was eventually established after further investigations showing a positivity for lysozyme and myeloperoxidase.

[Medical treatment for cerebral atherothrombosis].

Atherothrombotic ischemic stroke is associated with multiple vascular risk factors, including mainly hypertension, diabetes, and hyperlipidemia. Medical therapy of cerebral atherothrombosis implies control of these vascular risk factors and antithrombotic drugs as well. This paper reviews the current therapeutic guidelines according to the randomized trials for primary and secondary stroke prevention.

[Role of anti-CD20 monoclonal antibody in association with immunomodulatory agents].

Chimeric monoclonal anti-CD20 antibody (Rituximab) has been associated with immunomodulatory agents such as interferon alpha, interleukin-2, interleukin-12, G-CSF, GM-CSF and anti-CD22 humanized monoclonal antibody (Epratuzumab). Synergy with interferon is clearly demonstrated increasing complete response rate and response duration. Other associations are promising but must be tested in randomized prospective trials versus rituximab alone, probably in indolent lymphomas where chemotherapy could be avoided.

[The profile of memory disturbance in early Lewy body dementia differs from that in Alzheimer's disease].

It may be difficult to distinguish Lewy body dementia (LBD) from Alzheimer's disease (AD) especially at an early stage. Clinical diagnostic criteria for LBD still lack sensitivity. We compared memory performance in early AD and LBD to identify features that may help to distinguish these two conditions.