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Biomedical subjects

C Mayaud

Publications and source records attributed to C Mayaud.

At least 163 records · Page 9Linked to original sources
PubMed1987

Legionnaires' disease after bone marrow transplantation.

Four patients developed legionnaires' disease after bone marrow transplantation. Two cases occurred early after transplant and were considered as part of a hospital epidemic due to contamination of water supply. The other two cases were considered to be sporadic because they occurred 3-4 weeks after hospital discharge. The outcome was good in two patients. In the third patient, recurrent disease was probably due to acquired resistance to macrolides, and complete cure was achieved after treatment with pefloxacin and rifampicin. The fourth patient died of overwhelming infection despite early treatment with erythromycin and pefloxacin. During the same period we treated 14 patients with pefloxacin for prevention of bacterial infection, of whom none developed Legionella pneumophila infection, while three of the patients reported here were in a group of 11 patients who received only oral non-absorbable antibiotics for gut decontamination. The fourth patient in this report was receiving no antibiotics. Thus pefloxacin seems to be effective as prophylaxis against L. pneumophila infection. When the hospital water supply was heated to 60 degrees C and chlorinated, the nosocomial cases in the hospital completely disappeared.

Adult↗
PubMed1987

[Significance of the presence of Candida sp. in bronchopulmonary secretions. Contribution of pulmonary biopsy].

Candida SP is often found in broncho-pulmonary secretions (expectorations, bronchial aspirations, bronchiolo-alveolar lavage...); however, its presence even in massive amounts, is difficult to interpret. Is it a sign of broncho-pulmonary candidosis or mouth-pharynx contamination? The different clinical and biological elements, in particular immunology in immunodepressed patients, bring little information. In this article, we present the retrospective study of 18 patients hospitalized in Pneumology Department of Tenon Hospital for severe extensive pneumopathy of unexplained origin. In these patients, for the most part immunodepressed, Candida sp was found in large amounts in at least a sample (expectorations [5] and/or bronchial aspirations [4] and/or bronchiolo-alveolar lavage [12]. No lesion suggestive of candidiasis was found during bronchial endoscopy carried out for these different samples. In pulmonary biopsy with diagnostic in view, these yeasts were found only in one patient. In this patient, as C. tropicalis was associated with Pneumocystis carinii and Cryptococcus neoformans, it was difficult to know the respective part of each of these agents in pulmonary symptomatology. In the other 17 cases, the direct examination and cultures were negative. The presence of Candida sp in the different broncho pulmonary secretions is not synonymous of bronchopulmonary candidiasis; likely it is, in most cases, a sign of contamination of mouth-pharynx origin.

Adolescent↗
PubMed1987

[Isolated pulmonary lymphoma in a patient with acquired immunodeficiency syndrome].

We report the case of a male patient with AIDS who had been hospitalized for various opportunistic infections, from which he recovered, and was readmitted on account of a round opacity in the lower lobe of his right lung. There was no evidence of extrapulmonary pathology. Transtracheal aspiration, alveolar lavage and transbronchial biopsy failed to identify the lesion. Lung biopsy after thoracotomy resulted in a diagnosis of malignant lymphoma type B with anti-IgA and anti-kappa antibodies. Despite chemotherapy the patient died within one month, the lymphoma having spread to both lungs.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Value of the cytological examination of the bronchoalveolar lavage fluid in patients with acquired immunodeficiency syndrome and related syndromes].

In AIDS a variety of severe pulmonary disorders may occur. The authors report 110 cases of bronchoalveolar lavage (BAL) in 43 AIDS and 41 ARC. In AIDS P. carinii pneumonia is the major cause of respiratory illness. BAL alone is a safe and valuable tool for diagnosis of P. carinii pneumonia and others opportunistic infections. Moreover, pulmonary hemorrhage diagnosed by the finding of hemosiderin laden macrophages, is very suggestive of broncho-pulmonary Kaposi' sarcoma. Finally, BAL demonstrates a severe depletion of T4 lymphocytes and an increased number of T8 lymphocytes. The T8 lymphocytosis is observed whatever the pulmonary involvement (nonspecific alveolitis, opportunistic infections, Kaposi's sarcoma), and is also found in ARC, and lymphocytosis, open lung biopsy shows a lymphoid interstitial infiltration with respect of the alveolar septa, thus differing from the classical lymphoid interstitial pneumonia described by Carrington. The prognosis of lymphocytosis in ARC remains unknown.

Acquired Immunodeficiency Syndrome↗
PubMed1986

[Radiologic aspects of acute invasive pulmonary aspergillosis in 18 immunodepressed patients].

A retrospective study of 18 immunodepressed patients with acute invasive pulmonary aspergillosis enabled the radiologic picture of this increasingly frequent opportunist affection to be described, and different manifestations of the disease as a function of underlying conditions to be determined. Two groups could be distinguished: the first of patients with malignant blood diseases (n = 10) when the "aplasia" factor was dominant; the second of patients without blood diseases (n = 8) when the immunodepression was usually induced by a recent increase in corticoid therapy. Neutropenia was not a finding in any of these patients. The most frequent radiologic finding was single or multiple round excavating foci, these corresponding to zones of bronchopneumonia containing aspergillus filaments with central tissue necrosis forming the "target" lesion. The aplasia was distinguished by the multiplicity of lesions and their excavation following aplasia in the shape of a crescent due to sequestrum formation. Prognosis was related to severity of subjacent lesions. In the 2nd group, lesions could be single and nodular; prognosis was improved by the possibility of reducing immunodepression factors.

Acute Disease↗
PubMed1986

[Toxoplasma gondii pneumopathy in a patient with the acquired immunodeficiency syndrome: demonstration of the parasite by bronchioloalveolar lavage].

Toxoplasmosis is an infection frequently observed in patients with acquired immunodeficiency syndrome. Its first manifestations usually are cerebromeningal symptoms, but others may occur. A pulmonary lesion is sometimes present; it is discovered at post-mortem examination in most cases. The authors report a case of pulmonary toxoplasmosis diagnosed by bronchoalveolar lavage (BAL). Three points are emphasized: toxoplasmosis of the lung may produce an interstitial pneumonia similar to that of pneumocystosis; diagnosis can be made non-invasively by BAL, and provided an appropriate treatment is administered, the outcome may be favourable.

Acquired Immunodeficiency Syndrome↗
PubMed1985

[Pulmonary changes caused by cytostatic drugs].

About 80 drugs are known to cause lung disease. Cytostatic agents are the most common cause of this type of iatrogenic disease. In addition to the "intercalating" type of cytostatic, other groups, especially the alkylating (busulfan) and the antimetabolites groups (methotrexate), have also been incriminated. Cytostatic drug-induced lung disease is a difficult diagnosis based on the results of clinical, radiological, respiratory function, histopathological and biological investigations. The results of bronchoalveolar lavage are vital, especially in lung disease due to a drug hypersensitivity reaction; the diagnosis of drug-induced pulmonary fibrosis due to a toxic mechanism is much more difficult and risky. Early diagnosis of these drug-induced lung diseases is obviously important.

Alkylating Agents↗
PubMed1985

[Legionnaires' disease: 21 cases observed over 2.5 years in a Parisian respiratory intensive care unit].

The incidence of Legionnaire's disease is probably underestimated in France. Its clinical presentation is very suggestive, especially after the failure of a 48 hour therapeutic trial of beta-lactams, when a pneumococcal infection is initially suspected. This one sign is sufficient to orient the diagnostic survey and constitutes an indication for a therapeutic trial of macrolides for at least 72 hours. In fact, the delay in the diagnosis appears to be the determinant factor in the fatal outcome of the disease.

Adolescent↗