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Introduction: Infection by Fusobacterium necrophorum, a Gram negative anaerobic bacteria, can lead to the development of Lemierre's syndrome, an uncommon but potentially fatal infection of the internal jugular vein. Since the introduction of antibiotics, the morbidity and mortality associated with this syndrome have been dramatically reduced. This syndrome is characterized by a pharyngeal infection, which leads to the development of septic thrombophlebitis of the internal jugular vein with septic emboli, which usually spread into the lung. Sometimes the syndrome can be revealed by other unusual clinical symptoms., Case Report: We present the case of a young patient with an atypical pleural infection associated with pharyngeal infection and thrombosis from the internal jugular vein., Conclusions: The diagnosis of Lemierre's syndrome is mainly clinical, based on a range of suggesting symptoms. Confirmation and monitoring of the condition can be done by ultra-sound and/or contrast enhanced computed tomography. Treatment is based on long-term, high-dose antibiotic therapy and eventually surgical drainage of the infected collection with surgical excision of the internal jugular vein where there is extensive thrombosis. The important message is that in the context of a young patient without comorbidity, who presents with a significant infectious pleurisy, it is important to consider this clinical complication., (Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

The diagnosis of malignant pleural mesothelioma relies mostly on the pathological examination of pleural samples, validated by a panel of experts and generally obtained during medical or surgical thoracoscopy performed for the management of an exudative pleural effusion. In the absence of pleural effusion (dry-type mesothelioma), the diagnostic approach depends on the features of the lesions (pleural thickness, nodules and/or masses) and their pleural location. Ultrasound and CT-guided needle aspiration represent recognized alternative diagnostic techniques in these situations. We present the case of a patient, presenting a dry-type mesothelioma, whose diagnosis was obtained by endobronchial ultrasound (EBUS)-guided needle aspiration of a pleural mediastinal mass and confirmed by a CT-guided needle aspiration of another pleural mass in close contact with the chest wall. The samples have been compared and show quantitative and qualitative similarities. EBUS represents a minimally invasive alternative diagnostic technique for dry-type mesothelioma, showing thickness of the mediastinal pleura in contact with a central airway or when thoracoscopy, which remains the "gold standard" diagnostic approach, is not feasible., (Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

We report the case of a 49-years-old patient who presented to the accident and emergency department with sudden onset dyspnea associated with acute shoulder pain. He was breathless at rest with supine hypoxemia. He had an amyotrophic left shoulder with localized paresis of the shoulder. Both hemi-diaphragms were elevated on chest X-rays. Pulmonary function tests showed a restrictive pattern and both phrenic nerve conduction velocities were decreased. At night, alveolar hypoventilation was evidenced by elevated mean capnography (PtcCO2: 57mmHg). Neuralgic amyotrophy, Parsonage-Turner syndrome was the final diagnosis. This syndrome is a brachial plexus neuritis with a predilection for the suprascapular and axillary nerves. Phrenic nerve involvement is rare but where present can be the most prominent clinical feature as in our case report., (Copyright © 2014 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Modern immunosuppressive therapy may be responsible for toxic, immunologic and infectious pulmonary diseases., Case Report: We report the case of a 58-year old woman treated for rheumatoid arthritis who received leflunomide, corticosteroids, methotrexate and adalimumab. She developed disseminated tuberculosis, which presented with neurological symptoms (brainstem) and also pneumocystis pneumonia., Conclusion: Modern immunosuppressive therapy used to treat inflammatory disorders in connective tissue diseases and in transplantation may induce new respiratory diseases, new patterns of known respiratory diseases or co-infections that are very seldom seen outside the context of HIV. Pulmonologists, rheumatologists, internists and intensivists should be aware of this new spectrum of diseases whose presentation may be atypical., (Copyright © 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.)