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Biomedical subjects

A M Dumas

Publications and source records attributed to A M Dumas.

At least 19 recordsLinked to original sources
PubMed1991

Prolonged fever and pyuria: an uncommon manifestation of Q fever.

A patient with Q fever is described who had been ill for a year before the diagnosis was made on the basis of serological data. In addition it was possible to isolate Coxiella burnetii, the causative agent by culture from the urine. This is very exceptional and is to our knowledge only the second case in which this has been achieved. The patient made a full recovery after lengthy treatment with tetracycline. Q fever should be considered in patients with pyrexia of unknown origin, particularly in travellers.

Adult↗
PubMed1990

Subacute progressive sensory ataxic neuronopathy after Rickettsia conorii infection.

A case is presented in which sensory ataxic neuronopathy developed after serologically proven infection with Rickettsia conorii and continued to be progressive after appropriate antibiotic treatment. Electrophysiological studies showed decreasing sensory nerve conduction velocities ending with the absence of sensory nerve action potentials as well as peripheral and cortical somatosensory evoked potentials. Histological studies revealed a profound loss of myelinated fibres due to primarily axonal degeneration. The clinical course and the electrophysiological and histological findings suggest primary involvement of the dorsal root ganglion. Peripheral neuropathy due to infection with R. conorii is rare and usually of the mixed motor and sensory type. We believe this to be the first report of sensory ataxic neuronopathy associated with R. conorii infection.

Aged↗
PubMed1989

[Q-fever as a cause of myocarditis in childhood].

Q-fever occurs in The Netherlands in childhood more often than used to be believed. We treated an 8-month-old infant with congestive myocarditis associated with a seroconversion against Coxiella burnetii. The infection was probably caused by the father, who a few weeks earlier had visited his native Surinam, where he frequently was surrounded by domestic animals and drank raw cow's milk. After 2.5 years the child's general and cardial conditions are good although digoxin therapy is still necessary.

Antibodies, Bacterial↗
PubMed1989

[Nephrogenous diabetes insipidus caused by amphotericin B].

A patient on systemic amphotericin B therapy developed polyuria with low osmolarity of the urine probably due to nephrogenic diabetes insipidus. This rarely reported side effect of amphotericin B appears not to necessitate discontinuation of the treatment provided adequate fluid intake can be guaranteed. The diabetes insipidus is reversible in 2-6 months after cessation of the treatment: in our patient the polyuria and the low urine osmolarity disappeared within a few days.

Aged↗
PubMed1987

Evaluation of an enzyme immunoassay for detection of herpes simplex virus antigen in genital lesions.

To evaluate a non-marketed research prototype of a solid-phase enzyme immunoassay for detection of herpes simplex virus in genital lesions, 154 clinical specimens were collected from 127 men and 27 women with symptoms suggestive of herpes simplex virus infection (erythema, vesicles, ulcers and crustae). The samples were tested using the assay and cultures on four monolayers of human embryonic lung fibroblasts and Vero cells. When the culture was used as reference method, sensitivity was 76.9% and specificity 100% (prevalence 42.4%). Comparison of results by patient group showed that sensitivity was highest in material from patients with vesicles and ulcers. The highest sensitivity was obtained in specimens which developed a cytopathological effect within 48 h and in specimens with three or four positive cell cultures. These findings suggest that the assay is more successful in specimens with high virus titres. The enzyme immunoassay was found to be a rapid, moderately sensitive, highly specific test for detection of herpes simplex virus from genital lesions, but the usefulness of the assay is limited and culture methods should be preferred.

Animals↗
PubMed1987

Q fever in the Netherlands: a sero-epidemiological survey among human population groups from 1968 to 1983.

A sero-epidemiological survey, using an indirect immunofluorescence test for IgG against Coxiella burnetii (phase II), was carried out in the Netherlands. Serum samples taken in 1968, 1975, 1979 and 1983 were tested. Occupational groups with a supposedly high risk of infection (veterinarians, residents of dairy farms and taxidermists) showed a significantly higher percentage of seropositives than defined controls. The percentage of seropositive amateur wool spinners was significantly higher than that of the controls from the same region. Since 1968 there has been no increase in the percentage of infected persons, indicating that, contrary to earlier assumptions, Q fever has been endemic in The Netherlands for a long time already. The increase in numbers of notified cases of overt Q fever is considered to be the result of the recent introduction of a sensitive indirect immunofluorescence test for IgM antibodies against C. burnetii. Antibody percentages in all age classes between 1 and 64 years were much alike, suggesting that most infections occur in early childhood. This is in accordance with the finding that 35% of our patients are younger than 3 years. The possibility of infection related to childbirth and lactation is discussed.

Adolescent↗
PubMed1987

Rapid clearance of cytomegalovirus-specific IgG after repeated intravenous infusions of human immunoglobulin into allogeneic bone marrow transplant recipients.

We studied the kinetics of the disappearance of CMV-specific IgG from the serum of 18 allogeneic bone marrow transplant recipients who were receiving repeated intravenous infusions of immunoglobulin. Peak serum titers occurred 24-48 hr after infusion. The mean half-life of IgG to CMV varied from 30 to 70 hr. Additional studies showed that this unexpectedly short half-life was not specific for either the preparation used or the type of patient studied. Repeated treatment did not prevent patients from developing CMV infections (incidence, 50%); however, none of the patients developed CMV interstitial pneumonitis. Treatment had to be discontinued for one patient because of a serum sickness-like syndrome. Our results suggest that rational, time-sequential passive immunization regimens should be developed.

Antibodies, Viral↗
PubMed1985

[Coxiella burnetii as a possible cause of endocarditis in a 7-year old boy].

The case-history of a 7-year-old boy with endocarditis, myocarditis and pericarditis, possibly caused by Coxiella burnetii (Q-fever), is presented. As far as we know only one case of Q-fever endocarditis in a child is previously described in literature. That child had, contrary to our patient, a pre-existing valve abnormality. Q-fever was diagnosed after demonstration of a significant rise in titer of the antibodies against Coxiella burnetii in both the IgM and the IgG fractions. IgA antibodies, indicative for an endocarditis, were also demonstrated.

Acute Disease↗