M Laramas | PubMed Health

PubMed2004

Paraneoplastic acute diffuse encephalitis revealing Hodgkin's disease.

Paraneoplastic neurological syndromes are associated with various cancers. Cerebellar and limbic paraneoplastic manifestations are known to be associated with Hodgkin's disease (HD), but reports of diffuse encephalitis associated with HD are very rare. We report a case of acute severe diffuse encephalitis revealing a HD. Clinical presentation, cerebro-spinal fluid modifications and magnetic resonance imagery data are described. The treatment associated specific chemotherapy and plasma exchange. The neurological status improved dramatically within the first days of treatment, with parallel neoplasm regression. This case stresses the fact that encephalopathy can be the first sign of an undiagnosed extra-cerebral neoplasm.

Adolescent↗

PubMed2004

[Aspergillus flavus endocarditis on a native valve].

A 33 year old female had febrile aplasia following a first chemotherapy treatment for acute T lymphoid leukaemia. She was transferred to intensive care for acute respiratory distress due to bilateral pneumonia with Stenotrophomonas maltophilia septicaemic shock. After an initial improvement with antibiotic treatment, she developed multiple necrotic cutaneous lesions. A skin biopsy showed the presence of Aspergillus flavus in large quantities in the vascular lumina. Echocardiography revealed a voluminous vegetation on the mitral valve supporting aspergillus endocarditis. Despite antifungal treatment, shock and coma developed rapidly. Cerebral CT scan suggested multiple septic emboli. Within several hours, the scenario progressed towards multiorgan failure leading the death of the patient. Aspergillus endocarditis is exceptional and usually only occurs in immunosuppressed patients. The diagnosis is difficult, and the prognosis is appalling with a mortality greater than 90% despite treatment.

Adult↗