[Histoplasma capsulatum histoplasmosis: apropos of 1 case observed in the internal medicine department of the CHU of Treichville (Abidjan)]

The advent of AIDS has resulted in an increase in diseases which were previously rare. In HIV-infected subjects, histoplasmosis takes a disseminated and particularly severe form, with a fatal outcome in our country, the more so because the clinical presentation resembles tuberculosis and is generally treated as such. The authors report a case of disseminated histoplasmosis in a patient dually-reactive to HIV-1 and HIV-2, in whom the clinical presentation was fever, mediastinal lymphadenopathy and pulmonary infiltrates. The diagnosis of histoplasmosis was made at autopsy.

[Pain during peritoneum pinching, a pathognomonic sign of peritoneal disease. Clinical research. Semiological value]

Pain induced by pinching the peritoneum betrays a pathology of that membrane. It is absent when the peritoneum is perfectly healthy. Pain is elicited by a special palpation technique. Clinically and statistically, the presence of this pain is pathognomonic, but it does not inform on the aetiology. In the present study the most frequent causes of positive abdominal peritoneal pinching test were peritoneal tuberculosis, followed by portal hypertension with or without liver cirrhosis.

[Stopping persistent hiccups in the adult by endoscopic maneuver]

Thirty-four patients with persistent hiccups (median duration 10 days) were treated by gentle endoscopic massage of the region of the cardia. Hiccups stopped in all cases. Its early recurrence in one patient only required a second massage, which was also effective. This simple technique is recommended for the treatment of persistent hiccups.

[HIV1 seropositivity and B and D viruses in West Africa]

This study was undertaken to investigate relationships between three widespread viruses in West Africa, i.e. HIV1 and viruses B and D, in Ivory Coast. Serologic tests for viruses B and D were carried out in a random sample of black adults of both sexes with asymptomatic HIV1 seropositivity. Coinfection by virus B or viruses B and D was a common finding. Coinfection with both viruses B and D, but not with virus B alone, was found to be significantly more frequent in these HIV1-infected adults than in a control group with acute viral hepatitis. Potential interactions between the HIV1 and viruses B and D as well as other viruses are discussed. These findings suggest that one or several cofactors acting alone or in combination play a major role in the clinical expression of HIV infection. The results of this study, together with the suggestion put forward by several investigators that B virus infection may increase the severity of AIDS, are evidence in support of the value of immunization against the B virus in the management of AIDS.