Introduction In November 2002 an epidemic of atypical pneumonia appeared in the Chinese region of... more Introduction In November 2002 an epidemic of atypical pneumonia appeared in the Chinese region of Guandong. It was subsequently given the name “Severe Acute Respiratory Syndrome” (SARS) following the occurrence of further outbreaks in Hanoi and Hong Kong in February 2003. Five cases related to the same patient source have been reported in France. Case report We report the case of a patient of 52 years who had direct contact with a probable case of SARS. On admission the patient presented with pyrexia associated with lymphopenia and liver cell necrosis but no respiratory symptoms. The chest x-ray was normal. The thoracic CT scan showed a sub pleural ground glass appearance. Early (36 hours) PCR studies of naso-pharyngeal washings were negative for the coronavirus associated with SARS. The diagnosis was confirmed serologically. Conclusions This observation demonstrates the existence of incomplete clinical presentations of SARS. The infectivity of this asymptomatic form is unknown. Ser...
Médecine tropicale : revue du Corps de santé colonial, 2007
Numerous skin and mucosal manifestations were observed during the 2005-2006 chikungunya epidemic ... more Numerous skin and mucosal manifestations were observed during the 2005-2006 chikungunya epidemic in Reunion Island. A prospective study was carried out in a consecutive series of 212 patients treated for chikungunya at the emergency unit of the Saint-Pierre Hospital in Reunion Island from March 8 to April 27, 2006. Diagnosis of chikungunya was suspected in patients with fever and joint pain and confirmed by RT-PCR and/or serology (IgM). Skin involvement was observed in 50% of patients. It consisted of exanthema with patches of healthy skin mainly on the trunk and limbs that sometimes displayed diffuse, congestive and even edematous features. Itching was reported in some cases (19.3%) and was sometimes isolated. Peeling of the skin was observed in a few cases but remained uncommon in adults. Outcome was rapidly favorable in most cases sometimes with scaling or persistence of dyschromic patches. These findings suggest that chikungunya should be suspected in subjects presenting a febri...
The high frequency of the gene for sickle-cell hemoglobin in malaria-endemic regions is believed ... more The high frequency of the gene for sickle-cell hemoglobin in malaria-endemic regions is believed to be due to an advantage in surviving malaria. We report the case of a woman with both malaria and hemoglobin S.
Journal de gynécologie, obstétrique et biologie de la reproduction, 2012
Hemophagocytic syndrome is an uncommon but life-threatening complication of Herpes simplex virus ... more Hemophagocytic syndrome is an uncommon but life-threatening complication of Herpes simplex virus type 1 or 2 infection. Diagnosis is difficult to establish given the low specificity of clinical and biological signs.
In November 2002 an epidemic of atypical pneumonia appeared in the Chinese region of Guandong. It... more In November 2002 an epidemic of atypical pneumonia appeared in the Chinese region of Guandong. It was subsequently given the name "Severe Acute Respiratory Syndrome" (SARS) following the occurrence of further outbreaks in Hanoi and Hong Kong in February 2003. Five cases related to the same patient source have been reported in France. We report the case of a patient of 52 years who had direct contact with a probable case of SARS. On admission the patient presented with pyrexia associated with lymphopenia and liver cell necrosis but no respiratory symptoms. The chest x-ray was normal. The thoracic CT scan showed a sub pleural ground glass appearance. Early (36 hours) PCR studies of nasopharyngeal washings were negative for the coronavirus associated with SARS. The diagnosis was confirmed serologically. This observation demonstrates the existence of incomplete clinical presentations of SARS. The infectivity of this asymptomatic form is unknown. Serological analyses will allow...
La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne, 2003
Infection with Histoplasma capsulatum (Hc) is a rare importing disease in metropolitan France, th... more Infection with Histoplasma capsulatum (Hc) is a rare importing disease in metropolitan France, the most often minor but sometimes letal in its spread form. A 58 years old French man, HIV seronegative, was admitted for an alteration of its general condition, disorder and buccal ulcerations. He had a prostate cancer history and came back in France after 17 years in Central Africa. The imaging showed numerous cerebral nodes, a bilateral adrenal tumor, and pulmonary calcifications. Histoplasmosis diagnosis has been done after neurosurgical cerebral biopsy which displayed characteristic Hc. The sick man died 4 months later with multivisceral failures, in spite of amphotericine B treatment followed by oral then intraveinous itraconazole. Even in an old tropical residence, ones can be able to conjure up a deep exotic fungal infection, and most specifically Hc histoplasmosis, in front of meaningful multivisceral lesions. Disseminated histoplasmosis (HD) with neurological location is mislead...
Presse médicale (Paris, France : 1983), Jan 29, 2001
Mefloquine and pyrimethamine-sulfadoxine combination are recommended, as is quinine, for self-adm... more Mefloquine and pyrimethamine-sulfadoxine combination are recommended, as is quinine, for self-administered malaria prophylaxis. Patients should be carefully informed about appropriate use of this therapeutic scheme and advised on the importance of strict compliance to avoid overdose. We report the case of a patient who did not follow the prescribed dosage and who developed acute neurological disorders after overdosing. The patient developed seizures attributable to the sulfadoxine-pyrimethamine combination and mefloquine encephalopathy. Sulfadoxine-pyrimethamine-related seizures are exceptional and result from an overdose of pyrimethamine. The neurotoxicity of mefloquine is well-known and is particularly frequent at curative dosage. Toxic encephalopathy is a serious neurological manifestation which is slowly reversible depending on individual predisposition. Anti-malaria prophylaxis requires concerted efforts on the part of the traveler and the prescribing physician. Self-administra...
Presse médicale (Paris, France : 1983), Jan 15, 1997
Malaria is a major health priority. The aim of this study was to describe clinical expression, la... more Malaria is a major health priority. The aim of this study was to describe clinical expression, laboratory findings and therapeutic aspects of Plasmodium falciparum malaria observed in a French military population stationed in Gabon. One hundred fifty-four cases of P. falciparum malaria were observed between July 1, 1994 and February 29, 1996. In 145 cases malarial fever predominated and in 9 others further complications occurred. Mean age of the patients was 23.7 years and mean delay to consultation was 30 hours. Seventy-two percent of the patients stated they took prophylaxis (chloroquine-proguanil) regularly. Pain generally accompanied the episodes of fever. There were 21 atypical cases. Parasitemia was < 25000 HPM in 70% of the cases. Blood counts showed leukopenia, lymphopenia, and thombopenia. Plasma cholesterol was low and lactic acid dehydrogenase levels were elevated. Halofantrine was used for curative treatment (2 doses with a 7 day interval) in 145 cases. Intravenous qu...
The authors report a rare case of Yersinia enterocolitica O:3 pneumonia in an immunocompetent 70-... more The authors report a rare case of Yersinia enterocolitica O:3 pneumonia in an immunocompetent 70-year old man. There was no evidence of acute gastrointestinal disease. Diagnosis was confirmed by blood cultures. He responded with resolution of the infection after 21 days of therapy with a third-generation cephalosporin then by cotrimoxazole. Only 15 cases have been reported so far. Most of the patients were immunocompromised. This is the first case in France.
Introduction In November 2002 an epidemic of atypical pneumonia appeared in the Chinese region of... more Introduction In November 2002 an epidemic of atypical pneumonia appeared in the Chinese region of Guandong. It was subsequently given the name “Severe Acute Respiratory Syndrome” (SARS) following the occurrence of further outbreaks in Hanoi and Hong Kong in February 2003. Five cases related to the same patient source have been reported in France. Case report We report the case of a patient of 52 years who had direct contact with a probable case of SARS. On admission the patient presented with pyrexia associated with lymphopenia and liver cell necrosis but no respiratory symptoms. The chest x-ray was normal. The thoracic CT scan showed a sub pleural ground glass appearance. Early (36 hours) PCR studies of naso-pharyngeal washings were negative for the coronavirus associated with SARS. The diagnosis was confirmed serologically. Conclusions This observation demonstrates the existence of incomplete clinical presentations of SARS. The infectivity of this asymptomatic form is unknown. Ser...
Médecine tropicale : revue du Corps de santé colonial, 2007
Numerous skin and mucosal manifestations were observed during the 2005-2006 chikungunya epidemic ... more Numerous skin and mucosal manifestations were observed during the 2005-2006 chikungunya epidemic in Reunion Island. A prospective study was carried out in a consecutive series of 212 patients treated for chikungunya at the emergency unit of the Saint-Pierre Hospital in Reunion Island from March 8 to April 27, 2006. Diagnosis of chikungunya was suspected in patients with fever and joint pain and confirmed by RT-PCR and/or serology (IgM). Skin involvement was observed in 50% of patients. It consisted of exanthema with patches of healthy skin mainly on the trunk and limbs that sometimes displayed diffuse, congestive and even edematous features. Itching was reported in some cases (19.3%) and was sometimes isolated. Peeling of the skin was observed in a few cases but remained uncommon in adults. Outcome was rapidly favorable in most cases sometimes with scaling or persistence of dyschromic patches. These findings suggest that chikungunya should be suspected in subjects presenting a febri...
The high frequency of the gene for sickle-cell hemoglobin in malaria-endemic regions is believed ... more The high frequency of the gene for sickle-cell hemoglobin in malaria-endemic regions is believed to be due to an advantage in surviving malaria. We report the case of a woman with both malaria and hemoglobin S.
Journal de gynécologie, obstétrique et biologie de la reproduction, 2012
Hemophagocytic syndrome is an uncommon but life-threatening complication of Herpes simplex virus ... more Hemophagocytic syndrome is an uncommon but life-threatening complication of Herpes simplex virus type 1 or 2 infection. Diagnosis is difficult to establish given the low specificity of clinical and biological signs.
In November 2002 an epidemic of atypical pneumonia appeared in the Chinese region of Guandong. It... more In November 2002 an epidemic of atypical pneumonia appeared in the Chinese region of Guandong. It was subsequently given the name "Severe Acute Respiratory Syndrome" (SARS) following the occurrence of further outbreaks in Hanoi and Hong Kong in February 2003. Five cases related to the same patient source have been reported in France. We report the case of a patient of 52 years who had direct contact with a probable case of SARS. On admission the patient presented with pyrexia associated with lymphopenia and liver cell necrosis but no respiratory symptoms. The chest x-ray was normal. The thoracic CT scan showed a sub pleural ground glass appearance. Early (36 hours) PCR studies of nasopharyngeal washings were negative for the coronavirus associated with SARS. The diagnosis was confirmed serologically. This observation demonstrates the existence of incomplete clinical presentations of SARS. The infectivity of this asymptomatic form is unknown. Serological analyses will allow...
La Revue de médecine interne / fondée ... par la Société nationale francaise de médecine interne, 2003
Infection with Histoplasma capsulatum (Hc) is a rare importing disease in metropolitan France, th... more Infection with Histoplasma capsulatum (Hc) is a rare importing disease in metropolitan France, the most often minor but sometimes letal in its spread form. A 58 years old French man, HIV seronegative, was admitted for an alteration of its general condition, disorder and buccal ulcerations. He had a prostate cancer history and came back in France after 17 years in Central Africa. The imaging showed numerous cerebral nodes, a bilateral adrenal tumor, and pulmonary calcifications. Histoplasmosis diagnosis has been done after neurosurgical cerebral biopsy which displayed characteristic Hc. The sick man died 4 months later with multivisceral failures, in spite of amphotericine B treatment followed by oral then intraveinous itraconazole. Even in an old tropical residence, ones can be able to conjure up a deep exotic fungal infection, and most specifically Hc histoplasmosis, in front of meaningful multivisceral lesions. Disseminated histoplasmosis (HD) with neurological location is mislead...
Presse médicale (Paris, France : 1983), Jan 29, 2001
Mefloquine and pyrimethamine-sulfadoxine combination are recommended, as is quinine, for self-adm... more Mefloquine and pyrimethamine-sulfadoxine combination are recommended, as is quinine, for self-administered malaria prophylaxis. Patients should be carefully informed about appropriate use of this therapeutic scheme and advised on the importance of strict compliance to avoid overdose. We report the case of a patient who did not follow the prescribed dosage and who developed acute neurological disorders after overdosing. The patient developed seizures attributable to the sulfadoxine-pyrimethamine combination and mefloquine encephalopathy. Sulfadoxine-pyrimethamine-related seizures are exceptional and result from an overdose of pyrimethamine. The neurotoxicity of mefloquine is well-known and is particularly frequent at curative dosage. Toxic encephalopathy is a serious neurological manifestation which is slowly reversible depending on individual predisposition. Anti-malaria prophylaxis requires concerted efforts on the part of the traveler and the prescribing physician. Self-administra...
Presse médicale (Paris, France : 1983), Jan 15, 1997
Malaria is a major health priority. The aim of this study was to describe clinical expression, la... more Malaria is a major health priority. The aim of this study was to describe clinical expression, laboratory findings and therapeutic aspects of Plasmodium falciparum malaria observed in a French military population stationed in Gabon. One hundred fifty-four cases of P. falciparum malaria were observed between July 1, 1994 and February 29, 1996. In 145 cases malarial fever predominated and in 9 others further complications occurred. Mean age of the patients was 23.7 years and mean delay to consultation was 30 hours. Seventy-two percent of the patients stated they took prophylaxis (chloroquine-proguanil) regularly. Pain generally accompanied the episodes of fever. There were 21 atypical cases. Parasitemia was < 25000 HPM in 70% of the cases. Blood counts showed leukopenia, lymphopenia, and thombopenia. Plasma cholesterol was low and lactic acid dehydrogenase levels were elevated. Halofantrine was used for curative treatment (2 doses with a 7 day interval) in 145 cases. Intravenous qu...
The authors report a rare case of Yersinia enterocolitica O:3 pneumonia in an immunocompetent 70-... more The authors report a rare case of Yersinia enterocolitica O:3 pneumonia in an immunocompetent 70-year old man. There was no evidence of acute gastrointestinal disease. Diagnosis was confirmed by blood cultures. He responded with resolution of the infection after 21 days of therapy with a third-generation cephalosporin then by cotrimoxazole. Only 15 cases have been reported so far. Most of the patients were immunocompromised. This is the first case in France.
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