We report two imported cases of Corynebacterium diphtheriae infection in Paris in 2016 These two cases illustrate the epidemiology of diphtheria (Afgan refugee, French traveler), the clinical presentation (cutaneous, respiratory carriage), the potential consequences (toxin positive, toxin negative) The rising number of unvaccinated or incompletely vaccinated individuals, increased lnumber of imported cases, and growing vaccine skepticism could put Europe at risk of diphtheria. Résumé Introduction. La diphtérie est une maladie réémergente en Europe. En 2015, 36 cas ont été rapportés contre 53 cas de 2000 à 2009. Patients. Nous rapportons deux cas d'infection à Corynebacterium diphtheriae survenus en 2016 dans un hôpital français : une infection cutanée avec recherche de toxine négative chez un voyageur et un portage respiratoire avec recherche de toxine positive chez un réfugié afghan atteint d'une tuberculose pulmonaire. L'histoire vaccinale était inconnue pour le patient afghan.

A 63-year-old Caribbean man was admitted to the hospital for low back and pelvic pain. His medical history included sickle cell hemoglobin (Hb) C disease with no vasoocclusive crisis within the last 20 years, and chronic obstructive pulmonary disease treated with inhaled corticosteroids for the last 4 years. A few hours after admission, respiratory distress with polypnea occurred, requiring an oxygen flow rate of 12 L per minute. At that time, a thrombocytopenia was detected in peripheral blood, with a platelet count of 112,000/mm 3 , as well as increased hemolysis (LDH 4990 IU/L; normal range 125-250). He was transferred to the Intensive Care Unit. The patient's neurological and respiratory status got worse in the Intensive Care Unit, with agitation, confusion, and hypercapnic acidosis leading to his intubation. Disseminated intravascular coagulation, thrombocytopenia, and leukopenia developed. Chest computed tomography scan showed lung bilateral alveolar condensation in the posterior basal segment and bilateral pleural effusions. A bone marrow smear was performed and showed bone marrow necrosis. The diagnosis of pulmonary infection without bacterial identification was made; the patient required antibiotic therapy combination and blood transfusion. The wake-up after initial sedation was delayed and no real consciousness after 4 days without sedation was detected, therefore leading to further investigations. ASSESSMENT An electroencephalogram, a lumbar puncture, and a cerebral magnetic resonance imaging (MRI) scan were performed: Funding: None.

A 27-year-old Lebanese man was admitted to our department for multiple pulmonary lesions. The patient had reported persistent fever, cough, shortness of breath, and weight loss since his return from Lebanon 6 weeks earlier. He had been diagnosed with a severe form of Behçet disease 4 years ago, for which the ongoing treatment was a corticosteroid therapy associated with methotrexate and infliximab.