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Cerebral autosomal dominant arteriopathy with subcortical infarctions and leukoencephalopathy (CADASIL) was first reported in European families and since 1993 it has been observed in America, Africa and Asia, suggesting that today the disease probably still remains largely underdiagnosed. CADASIL appears to be essentially a disorder of the arteries linked to single missense mutations in the Notch3 gene locus on chromosome 19; the aberrant dimerisation of Notch3, due to abnormal disulphide bridging with another Notch3 molecule or with another protein, may be involved in the pathogenesis of the disorder. It is characterized by recurrent stroke episodes and focal neurologic deficits progressing to pseudobulbar palsy and dementia, caused by multiple lacunar infarctions with ischemic and diffuse white matter abnormalities on neuroimaging. Migraine with aura, epileptic seizures and affective disorders are frequent additional symptoms of CADASIL. It is usually observed in the 3rd decade, but some individuals remain asymptomatic close to the age of 60. MRI displays a marked leukoencephalopathy in affected individuals as early as in the age of 20. The authors emphasize the role of a direct DNA test for gene mutation to make a differential diagnosis between CADASIL and other forms of vascular leukoencephalopathy as Alzheimer's dementia, multiple sclerosis and Binswanger's subcortical arteriopathic encephalopathy where CADASIL's arteriopathy is characterized by major alterations of vascular smooth muscle cells and the presence of specific granular osmiophilic deposits.

Visceral arteries aneurysms are an uncommon pathology. Lienal artery (60%), hepatic (20%), superior mesenteric (5.9%) and tripod celiac (4%) are the most involved. Female predominance, portal hypertension, arteriosclerosis, pregnancy, traumatic and infective factors are the most remarkable etiopathogenetic factors. Portal hypertension with splenomegaly might be an important factor in the pathogenesis of intra- and extraparenchimal splenic artery aneurysms. Stress is laid on the importance of arteriography during portal hypertension in pregnancy as a preventive measure because the rupture of aneurysm of the splenic artery, despite laparotomy in emergency is often fatal, and of coeliac angiography prior to liver transplantation; if splenic artery aneurysm is found, ligation of the splenic artery should be performed at the time of transplantation to prevent possible rupture. The different roles of the imaging techniques used are examined.

Myiasis is the invasion of tissue by larvae of flies. They parasitize living tissues (specific myiasis) or cavity of warm blood animals compulsorily, optional (hemispecific myiasis) or accidentally (accident myiasis). It is frequent in sub-saharian Africa, while in European countries only imported cases are described. A case personally observed and some measures for prevention are described.

Background: The diarrhea, often associated with growing thin and weight loss, is important for nutritional state and quality of life in AIDS patients. It was demonstrated that patients with AIDS who present diarrhea have a greater degree of immunosuppression than those without diarrhea, predisposing the gastrointestinal tract to the action of protozoa, bacterial, viral, fungal pathogens which may cause morbidity and death. HIV-patients are particularly susceptible to protozoa infections. Cryptosporidium infection is among the most common causes of enteric disease but Microsporidium (Enterocytozon bieneusi) and Cyclospora are emerging as potentially important enteric pathogens in AIDS patients. In spite of frequent interest of gastrointestinal tract the knowledge of diarrhea syndromes AIDS-related are often greatly limited by diagnostic difficulties., Objective: A review is made of the different laboratory methods employed in intestinal microparasitosis in the light of considerable dangerousness and aggressiveness of some protozoa on HIV-patients., Methods: The methods for the diagnosis of intestinal microparasitosis are based particularly on direct diagnosis (macroscopic or microscopic examination at fresh or after concentration) or an immunological diagnosis., Results: The laboratory methods available at present permit to evidence different protozoa not evidenced in the past and without invasive techniques., Conclusions: The etiological diagnosis of diarrhea in AIDS-patients is often difficult and/or disappointing. Epidemiological knowledge on protozoa pathology has been limited by diagnostic difficulties but their identification is important particularly because an increasing therapeutic regimens are now available to treat these infections.

A case of posthepatitis A aplastic anemia is described. The pathogenesis of this rare complication of viral hepatitis type A infection is underlined.

Tropical pyomyositis is an infection of large muscle groups that can lead to sepsis and death. The most common etiologic agent is Staphylococcus aureus. It usually occurs in patients living in the tropics but is seen with increasing frequency in temperate climates, particularly in immunosuppressed patients, where it may be misdiagnosed and may cause severe morbidity and mortality. Diagnosis is based on the examination of pus from a muscle aspirate and treatment consists of surgical incision, drainage and appropriate antibiotic therapy. It is stressed to take into account pyomyositis in the differential diagnosis of immunocompromised patients with "cryptic" myalgia.

A case of cytomegalovirus pneumonia occurring in a patient affected with AIDS is reported. The treatment of this disease is still difficult and remission of CHV-pneumonia after therapy with foscarnet is emphasized.

A case of Norwegian scabies in an immuno-suppressed patient is reported. This skin ectoparasite, rarely described in healthy individuals, varies from common scabies for clinical presentation, appearance and distribution of skin lesions. Norwegian scabies should be suspected in any atypical itching, or non, rash in immunosuppressed patient. Attention is also drawn to the importance of early diagnosis to precede familiar and hospital epidemics.

The authors describe a case of visceral leishmaniasis in an intravenous drug abuser, HIV seropositive patient. Visceral leishmaniasis was the first opportunist infection and diagnosis was based on smear from bone marrow. A treatment with N-methylglucamine and allopurinol was successful. The authors stress to take into account visceral leishmaniasis in HIV-infected patient in act resident or in past lived in endemic for Leishmania areas even in presence of atypical clinical features and propose to include visceral leishmaniasis as an opportunist infection in the IVC-2 group of clinical classification of HIV infection.