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Biomedical subjects

D Floret

Publications and source records attributed to D Floret.

At least 19 recordsLinked to original sources
PubMed1999

[Hydration and meningitis].

For almost 20 years, fluid restriction has been applied in the management of bacterial meningitis. This recommendation was based upon the findings of elevated plasma levels of arginine vasopressin in children with bacterial meningitis and their interpretation as evidence for inappropriate secretion of antidiuretic hormone. Recent data indicate that this interpretation was erroneous and that elevated levels of arginine vasopressin is the consequence of hypovolemia in the majority of cases of bacterial meningitis. In addition, fluid restriction appears to worsen the prognosis. As a consequence, not only fluid restriction must not be systematically applied in the management of bacterial meningitis, but appropriate fluid and sodium intakes are necessary to compensate hypovolemia and dehydration. Only a small number of cases with evidence of inappropriate secretion of antidiuretic hormone will require fluid restriction.

Arginine Vasopressin↗
PubMed1999

Evaluation of combining upper respiratory tract swab samples with cerebrospinal fluid examination for the diagnosis of enteroviral meningitis in children.

In a prospective comparative study, the use of combined analysis of upper respiratory tract swab samples and cerebrospinal fluid (CSF) samples was assessed to improve the detection rate of enteroviral meningitis in children. An enterovirus was detected in 32% of patients with aseptic meningitis when testing CSF samples alone compared with 71.5% when combining CSF and respiratory tract findings. An enterovirus was detected in 17% of respiratory tract samples in an age- and sex-matched control group without meningitis. Thus, combining the examination of upper respiratory tract with CSF findings may improve the detection rate of enteroviral meningitis. Upper respiratory tract samples should be included in the diagnosis scheme to differentiate benign enteroviral meningitis from other life-threatening infections of the central nervous system.

Adolescent↗
PubMed1998

[Mumps].

Explore the source record for details and available documents.

Child↗
PubMed1998

Cost of varicella in France: a study in day care centers.

To assess the cost of varicella in young children in France, a prospective study was done in day care centers. Children (1263), who were 3 months to 3 years old and attending day care, were followed over a varicella season. For every child who developed varicella (n = 200), detailed information was obtained by use of parental questionnaires. Questions concerned medical care, days missed from work for parents, and the need for extra baby-sitting. On average, each sick child had one consultation with a physician and received three medications. In half of the families (52%), at least 1 parent had to miss work an average of 4.5 days to care for a sick child. Total costs to society were estimated to be US$352 per family, with medical costs accounting for 22% of the cost. The average eventual cost to parents was $89 per family, including $80 of non-medical costs. This study emphasizes the important socioeconomic impact of varicella in the day care setting in France.

Chickenpox↗
PubMed1997

[Febrile purpura in children].

The association of fever and purpura should first suggest the diagnosis of fulminant meningococcemia, owing to the severity of this condition. Compromise of peripheral circulation (cyanosis, prolonged refilling time) is important to consider, because normal blood pressure is usually observed at an early stage of a septic shock in children and particularly in young infants. When this hypothesis has been eliminated, other causes of febrile purpura can be considered: meningococcal meningitis; measles or other viral diseases; non infectious causes include mechanical purpura, Schönlein-Henoch's purpura and thrombocytopenia. In the frequent case where no cause has been found, the diagnosis of occult bacteriaemia should be considered, leading to parenteral administration of antibiotic following blood and cerebrospinal fluid cultures.

Chickenpox↗
PubMed1997

[Biological diagnosis of whooping cough: contribution of gene amplification].

An upsurge in pertussis infections, despite mandatory vaccination in France since 1966, has occurred again in developed countries due to progressive loss of vaccinal immunity and wider circulation of the causal bacterium, Bordetella pertussis. Unfortunately, the classical culture method is insufficiently sensitive and serology can only confirm diagnosis retrospectively. New techniques are needed for rapid diagnosis, and subsequent treatment and preventive measures. One new method, gene amplification using polymerase chain reaction (PCR), has been particularly useful in detecting Bordetella pertussis. PCR is highly specific and more sensitive than culture. It is thus quite useful in case of atypical clinical presentations and in previously treated or vaccinated patients. Less restrictions on sample transportation and preservation make PCR a technique which general practitioners can use for rapid easy diagnosis of pertussis.

Bordetella pertussis↗
PubMed1997

[Clostridium perfringens meningitis with fatal outcome in a 3-week old infant].

BACKGROUND: Clostridium perfringens meningitis is a rare condition usually associated to skull injuries, surgery or gastro-intestinal disorders. CASE REPORT: A 21 day-old infant was admitted for the sudden worsening of a neonatal post-hemorrhagic hydrocephalus. Eighteen hours after admission, she developed a septic status with acute meningitis. A CT scan revealed the presence of intracerebral gas suggesting the responsibility of an anaerobic bacterium. The infant died within 24 hours from multiorgan failure, hemodynamic disorders, acute anemia with red urines. Clostridium perfringens was isolated both from the blood and CSF. CONCLUSIONS: The tissue alterations following meningeal hemorrhage may favor anaerobic growth. The presence of intracerebral gas is highly suggestive of the diagnosis. The prognosis is very poor.

Cerebral Hemorrhage↗
PubMed1997

[Virus-bacteria co-infections].

Influenza is the best known model of bacterial-viral co-infection. Epidemics of influenza result in an increased hospital admission rate for bacterial pneumonia due to pneumococcus, Haemophilus influenzae and Staphylococcus aureus. Similarly, an increased incidence of meningococcal diseases, particularly severe forms, follows the influenza outbreaks, with a two week delay. Though the precise mechanism is not known, the depression of host's phagocytes bactericidal activity by the influenza virus seems to be involved. An increased incidence of invasive group A beta hemolytic streptococcal infections, particularly necrotizing fasciitis and toxic shock syndrome, is also observed in relation with chickenpox. The reason for this association is unclear and appears not to be limited to the disruption of the cutaneous barrier which leads to the cutaneous infections in this disease. Bacterial-viral co-infection is not a justification for a systematic antibiotic prescription in viral diseases. Severe bacterial disease will be best prevented through viral immunization, thus encouraging the development of viral vaccines and immunization campaigns.

Animals↗