Rare cases of Cryptococcus have been documented in patients living with multiple myeloma. To date there has been no documented evidence of cryptococcosis revealing multiple myeloma. We reported a 63-year-old man who had a 2-months history continuous holocranial headaches, morning vomiting, complaining of blurred vision and fever. The biologic and the imaging showed a Cryptococcus meningoencephalitis. The search for a cause of immunodeficiency revealed a multiple myeloma. The diagnosis for Cryptococcus was confirmed according to an India ink stain, blood and cerebrospinal fluid culture. The patient's treatment for multiple myeloma was initiated with a chemotherapy regimen. The evolution was good without complication. Cryptococcosis, especially in the neuro-meningeal form, is a serious, deadly opportunistic infection. The search of an underlining immunodeficiency must be systematic. In this case, it was associated with early stage multiple myeloma.
La coagulation intravasculaire disséminée (CIVD) est une cause de mortalité redoutable en milieu de réanimation. L´utilisation du système de score de la société internationale sur la thrombose et l´hémostase (ISTH) permet de faciliter le diagnostic précoce de la CIVD. Nous présentons trois observations cliniques de CIVD d´étiologies différentes: un adénocarcinome prostatique, un choc septique et un hématome rétro-placentaire. Les tests d´hémostase nécessaires au calcul du score de la Société Internationale sur la Thrombose et l´Hémostase (ISTH) (numération plaquettaire, taux de prothrombine, fibrinogène et D-dimères) ont été régulièrement réalisés. D´autres tests complémentaires (recherche de complexes solubles, test de lyse des euglobulines, dosage des taux d´antithrombine, de protéine C activée et du facteur V) ont été également réalisés. L´utilisation du score ISTH permet de faciliter le diagnostic précoce de la CIVD.
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