COVID-19 and dengue co-infection in a returning traveller

Stingray injuries to the chest are rare but potentially life-threatening. They may occur in remote areas where advanced emergency healthcare services are unavailable. We describe the case of a 24-year-old man with tension pneumothorax due to a Himantura fai stingray injury to the left chest. The chest wound was unremarkable, with no external bleeding or evidence of a foreign body. Decompression was performed at the scene with an improvised knife procedure and a hollow writing pen, which served as a chest tube. At the local hospital, a standard-sized chest tube was inserted, the wound cleaned, and the patient given antibiotics active against marine organisms. Computed tomography visualized the stinger and revealed hemopneumothorax and pneumomediastinum. The local hospital did not have a thoracic surgeon, and the patient was transferred to a larger hospital with a thoracic surgery center. After surgical removal of the stinger, segmental lung resection was required to control bleeding. Management of life-threatening stingray injuries to the chest should begin at the scene. After stabilization, the patient should be transferred to a hospital equipped for cardiovascular and thoracic surgery. Surgery may be required to remove the retroserrated stinger and can be challenging.

Post-malaria neurologic syndrome (PMNS) is a rare complication following a Plasmodium falciparum infection and its pathophysiology remains unclear. This is the first report of a pediatric PMNS following an infection acquired in Africa and the fourth description of pediatric PMNS overall. Neither intrathecal synthesis of Immunoglobin G nor specific P. falciparum antibodies were found in the cerebrospinal fluid.

Melioidosis is an emerging disease caused by the environmental Gram-negative bacillus Burkholderia pseudomallei. Melioidosis has been reported to be endemic mainly in northern Australia and Southeast Asia. Here, we report the first two cases of melioidosis on the Comorian island of Mayotte. Wealso describe four cases that occurred over a short period of time in patients who had traveled between Mayotte, Madagascar, and Reunion Island.

Les dermohypodermites bactériennes nécrosantes associées ou non aux fasciites nécrosantes sont des infections bactériennes rares chez l’enfant. Parmi les facteurs de prédisposition, on retrouve la varicelle et les traumatismes. Il est important de reconnaître tôt ces infections avant l’apparition de complications, notamment l’extension des plages de nécrose et le choc septique. La prise en charge thérapeutique est médicochirurgicale et nécessite une hospitalisation dans une unité de réanimation pédiatrique. Pour les infections cervicales, périorbitaires et périnéales, l’imagerie par résonance magnétique et la tomodensitométrie peuvent apporter une aide intéressante pour déterminer l’extension de la nécrose dans les tissus profonds. Cependant, les indications doivent être discutées en fonction des territoires incriminés et le délai de réalisation ne doit pas retarder la prise en charge. Le streptocoque β-hémolytique du groupe A (Streptococcus pyogenes) est le microorganisme prépondérant de ces infections, bien que l’incidence de Staphylococcus aureus, sécréteur ou non de toxines, soit en constante augmentation. Le décès survient chez 5 à 20 % des patients. Le pronostic dépend de la précocité du diagnostic et de la rapidité de mise en route de l’antibiothérapie et du traitement chirurgical. Cette prise en charge multidisciplinaire en urgence est parfois difficile à organiser chez l’enfant, compte tenu de la rareté de ces infections.