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Cutibacterium acnes est un germe de la flore commensale de la peau, responsable d'infections associées aux prothèses surtout au niveau de l'épaule. Il est extrêmement rare dans les arthrites septiques des membres inférieurs. Ce travail rapporte un cas d'arthrite septique du genou à C. acnes. Le diagnostic a été établi à partir des cultures d'enrichissement prolongées. Le but de ce travail est de mettre en exergue l'importance d'enrichir le liquide articulaire sur les flacons d'hémoculture, et de prolonger les cultures pendant au moins deux semaines afin d'augmenter la sensibilité diagnostique pour les germes atypiques, notamment C. acnes. Cutibacterium acnes is a germ of the commensal flora of the skin, responsible for infections associated with prostheses, especially at the shoulder level. It is extremely rare in septic arthritis of the lower limbs. This work reports a case of septic arthritis of the knee caused by C. acnes. The diagnosis was established from prolonged enrichment cultures. The aim of this work is to highlight the importance of enriching the joint fluid on blood culture bottles, and of extending the cultures for at least two weeks in order to increase diagnostic sensitivity for atypical germs, particularly C. acnes. [ABSTRACT FROM AUTHOR]

Le syndrome de Willebrand acquis est un trouble rare de la coagulation se développant chez des patients sans antécédents personnels et familiaux de saignement, dont les caractéristiques cliniques et biologiques sont similaires à ceux des formes constitutionnelles. Il a été le plus souvent signalé chez des patients présentant diverses maladies sous-jacentes, notamment une gammapathie monoclonale, des troubles lymphoprolifératifs, des syndromes myéloprolifératifs ou des maladies auto-immunes. Chez les patients présentant des saignements d'apparition récente, des examens cliniques et biologiques approfondis sont nécessaires pour en déterminer la cause sousjacente. Le syndrome de Willebrand acquis est potentiellement grave. Il doit être évoqué chez l'adulte devant un syndrome hémorragique cutanéomuqueux inhabituel avec ou sans allongement du temps de céphaline avec activateur et confirmé par le dosage de l'activité et de l'antigène du facteur de von Willebrand. Une maladie associée hématologique, néoplasique ou valvulaire cardiaque doit être recherchée. Le traitement substitutif ne donne pas toujours de bons résultats, seul le traitement de l'affection sous-jacente, lorsqu'il est possible, permet dans certains cas de corriger le syndrome de Willebrand acquis. Nous présentons ici un cas de déficit acquis majeur en facteur de Willebrand secondaire à un myélome multiple à IgG Kappa chez un patient de sexe masculin. Acquired Willebrand syndrome is a rare coagulation disorder developing in patients without a personal and family history of bleeding, whose clinical and biological characteristics are similar to those of constitutional forms. It has been most commonly reported in patients with a variety of underlying diseases, including monoclonal gammopathy, lymphoproliferative disorders, myeloproliferative syndromes, or autoimmune diseases. In patients with new onset bleeding, thorough clinical and laboratory investigations are necessary to determine the underlying cause. Acquired Willebrand syndrome is potentially serious. It should be consideredin adults when faced with an unusual mucocutaneous hemorrhagic syndrome with or without prolongation of the partial thromboplastin time with activator and confirmed by the determination of von Willebrand factor activity and antigen. An associated hematological, neoplastic or cardiac valve disease should be sought. Substitution treatment does not always give good results; only treatment of the underlying condition, when possible, allows in certain cases to correct acquired Willebrand syndrome. We present here a case of major acquiredWillebrand factor deficiency secondary to IgG Kappa multiple myeloma in a male patient. [ABSTRACT FROM AUTHOR]

Background: We report a case of a patient with immunoglobulin A multiple myeloma associated with a masked kappa light chain. Serum immunofixation showed a monoclonal band in the IgA heavy chain lane without correspondence with the light chain and a monoclonal band in total kappa light chain lane without correspondence with the heavy chain. Methods: To distinguish between heavy chain disease and immunoglobulin with "masked" light chains, two tubes containing the patient's serum were incubated with a very high concentration of anti-total kappa and anti-total lambda antisera for 48 hours at 4°C in order to facilitate immunoprecipitation of the involved light chain. After centrifugation, the supernatant was analyzed by using the IFs method on the Hydrasys 2 Scan Focusing Sebia® without dilution. Then we applied the anti-IgA, anti-total kappa and anti-total lambda antisera. Results: The serum immunofixation test of the sample treated with a high concentration of anti-total kappa showed the disappearance of the monoclonal bands corresponding to IgA heavy chain lane and kappa light chain lane, indicating that precipitation had occurred and that the IgA did have kappa light chains that could not be detected by the standard immunofixation protocol. The serum immunofixation test of the sample treated with antitotal lambda showed the disappearance of the polyclonal background in lambda light chain lane, confirming that the precipitation with lambda light chains according to the previously mentioned protocol has done well. Conclusions: This case illustrates some of the difficulties encountered and the corrective actions that can be taken for the detection of immunoglobulins with masked light chains. [ABSTRACT FROM AUTHOR]

Introduction. Peritonitis is characterized by acute inflammation of the peritoneum, often resulting from digestive organ perforation or intra-abdominal septic focus. It may be of either infectious or non-infectious origin. The bacteria involved are those of the digestive flora ( Enterobacteriaceae and anaerobes), while Gram-positive cocci and yeasts can be isolated in nosocomial infections. Our study aims to isolate and identify the germs involved in community-acquired peritonitis in order to assess their susceptibility to the antibiotics available in our country. Methods. This is a retrospective study of the bacteriological profile of community peritonitis in Rabat Morocco. A total of 150 adult patients with peritonitis were admitted and samples were collected intraoperatively for bacteriological examination between 1 July 2022 and 30 April 2023. Results. Among the 150 patients, 101 (67.8%) were males and 49 (32.2%) were females, with a sex ratio (M/F) of 2 : 1. The mean age of the patients was 40.5 years±20.12. The distribution of bacteria was dominated by Escherichia coli (44%). Overall, 70% of E. coli isolated exhibited resistance to ampicillin, whereas no resistance to ampicillin has been reported for Enterococcus . Discussion. In the present study, we were interested in the bacteriological profile of community peritonitis in order to adapt the antibiotic therapy to our bacterial ecology. Our findings indicate a concerning trend of increasing resistance among E. coli to the commonly used amoxicillin/clavulanic acid combination in our clinical setting. Conclusion. Consequently, there is a need to reassess the empiric antibiotic prescribed for the management of community-acquired peritonitis., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2024 The Authors.)

Appendicitis, typically caused by appendiceal lumen obstruction, is a prevalent abdominal surgical emergency worldwide. While most cases involve Enterobacterales, Haemophilus influenzae , primarily known for upper respiratory infections, is infrequently associated with gastrointestinal infections. This article presents an exceptional case of acute appendicitis caused by both Haemophilus influenza and Enterobacter cloacae in a 15-year-old child, highlighting the significance of recognizing uncommon pathogens in appendicitis and emphasizing the necessity for thorough microbiological investigations to refine diagnostic approaches., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2024 The Authors.)

Tuberculosis is an infectious disease that most often affects the lungs, caused by human-to-human transmission of Mycobacterium tuberculosis . Peritoneal tuberculosis is an extra-pulmonary form of the disease that usually manifests as an ascitic syndrome, with or without fever, in a context of altered general condition, often in endemic areas. The diagnosis of peritoneal tuberculosis is not always easy, as the clinical signs are often insidious and unspecific. We report a case of peritoneal tuberculosis in an 18-year-old female, who had presented for 10 days with a progressive increase in abdominal volume associated with vomiting and diarrhoea., Competing Interests: The authors declare that there are no conflicts of interest., (Copyright © 2024 The Authors.)