[Differential diagnosis of systemic vasculitis: malignant rickettsiosis].
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Biomedical subjects
Publications and source records attributed to O Brocq.
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We report the case of a 46-year-old patient in whom ulcerative colitis had been diagnosed three years ago. He was admitted to the hospital for swelling of the nose. Clinical course and complementary exams led us to diagnose atrophic polychondritis. Twelve cases of such an association have been published so far.
BACKGROUND: Sympathetic reflex dystrophy is an uncommon cause of pelvic pain not to be overlooked in pregnant women. CASE REPORT: At 8 months pregnancy, a 27-year-old woman complained of invalidating pain of the left hip. Magnetic resonance imaging of the pelvis performed the day after delivery evidenced a non-displaced fracture of the femoral neck and a typical aspect of sympathetic reflex dystrophy. DISCUSSION: The true frequency of sympathetic reflex dystrophy during pregnancy is probably underestimated. Approximately one hundred cases have been reported. The hip joint is involved in 9 out of 10 cases. Such localizations are uncommon outside pregnancy, accounting for 14 to 17% of all cases.
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Sacral insufficiency fractures are not rare. They are well known in female patients over age 50 with osteopenia. One case occurring in a young pregnant woman is described. We did not find another case in the literature.
Reactive arthritis induced by Strongyloides is exceedingly rare. A case in a 53-year-old man from the Guadeloupe (French Antilles) is reported. The outcome was rapidly favorable under thiabendazole therapy. The cycle of Strongyloides is reviewed, and the contribution of parasites to reactive arthritis in patients with genetic risk factors is discussed. Establishing the correct diagnosis is sometimes difficult but is essential in order to avoid inappropriate administration of corticosteroids that can lead to fatal, multivisceral dissemination of the parasite, particularly in patients with strongyloidiasis.
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Fracture of the posterior ring apophysis in association with a herniated disk is unusual in adult patients. It has to be considered as a posterior pre-marginal disk hernia, a variant of marginal cartilaginous nodes. This report concerns one young adult with lumbar and sciatic pain presenting a posterior marginal node with fracture of the posterior ring apophysis and conventional posterior disk herniation. Computed tomographic findings and magnetic resonance images are described.
We describe an uncommon case of cervical pyomyositis in a 60-year-old woman without predisposing factors, admitted for cervicobrachial neuralgia with fever and paravertebral contracture. Ultrasonography and computed tomography (CT) showed a collection in the left longissimus capitis. Ultrasonography guided needle aspiration yielded thick pus, which cultured Staphylococcus aureus. Our patient completely recovered after antibiotherapy. Pyomyositis is rare and most commonly affects rhizomelic muscles (cervical localization is extremely rare) and occurs in patients with predisposing factors. Staphylococcus aureus is responsible for over 85% of cases; ultrasonography and CT scan are useful for abscess localization and aspiration.
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