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Biomedical subjects

C Cordonnier

Publications and source records attributed to C Cordonnier.

208 records · Page 12Linked to original sources

Posttransplantation lymphoproliferative disorder mimicking a nonspecific lymphocytic pleural effusion in a bone marrow transplant recipient. A case report.

BACKGROUND: Serous effusions are rare complications of bone marrow transplantation (BMT) and result mainly from infections or tumor relapse. CASE: We report a case of posttransplantation lympho-proliferative disorder (PTLD) revealed by cytodiagnostic examination of serous effusions in a BMT recipient. The effusion was initially considered reactive, but morphologic, immunocytologic and molecular studies subsequently revealed PTLD. CONCLUSION: This case demonstrates the importance of cytologic examination of effusions in BMT or organ recipients. Since most PTLDs are Epstein-Barr virus (EBV)-associated B-cell lymphoproliferative disorders and T cells predominate in reactive effusions, appropriate initial immunostaining, including CD3, CD79a and EBV latent membrane protein, should aid in their early detection.

Acute Disease↗

[From epidemiology to therapeutic choices. Infections in patients with neutropenia].

CHANGING EPIDEMIOLOGY: In hermtology units, Gram positive germs are becoming more predominate than Gram negative germs for reasons related both to changing clinical practices and to the epidemiology of infectious diseases. Nevertheless, mortality due to Gram negative germs, particularly Pseudomonas, remains high and justifies continued application of a rule established more than 20 years ago concerning the requirement, in neutropenic patients, to aim antibiotics against the most eminetly dangerous germs. FOR HIGH RISK PATIENTS: Patients with severe prolonged neutropenia, the betalactam-aminoglycoside combination is still indicated in most cases due to its spectrum, bacteriocidal rate and synergetic action. According to the most recent randomized trials, adding a first intention glycopeptide, except in specific situations (suspected infected catheter, high incidence of methicillin-resistant Staphylococcus aureus), would not be justified. FOR LOW RISK PATIENTS: Single drug regimens are still indicated if a wide spectrum compound is used, especially for Gram negative germs. Several trials in outpatients have been attempted, but patients selection criteria remain to be defined. WHICH ANTIBIOTIC? Choosing the right antibiotic, for both high-risk and low-risk patients, requires knowledge of the causal germs generally encountered in the unit. The choice may vary over time depending on germ ecology within the unit and whether an in- or out-patient is to be treated.

Anti-Bacterial Agents↗