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D Sainte-Marie

Publications and source records attributed to D Sainte-Marie.

36 records · Page 2Linked to original sources
PubMed1999

[Disseminated histoplasmosis detected by lingual and tonsillar erosions in an immunocompetent patient].

BACKGROUND: Histioplasmosis is a usually asymptomatic fungal infection. In the immunocompetent patient, it leads to chronic disseminated infection. Mucosal involvement is common and can provide the diagnosis. CASE REPORT: A metropolitan Frenchman with a history of alcoholism and smoking and living in Guyana consulted for lingual and tonsil erosion. Squamous cell carcinoma was suspected but not confirmed at pathology. The patient had a bi-apical infiltration on the chest x-ray and was treated empirically for tuberculosis. The diagnosis of histoplasmosis was reached when rare Histoplasma capsulatum were evidenced from a buccal swab. Itraconazole led to cure in 6 months. DISCUSSION: This case illustrates the importance of mucosal signs in the diagnosis of disseminated histoplasmosis in immunocompetent subjects. Histoplasmosis is rarely the cause of active infection in immunocompetent subjects. In these patients, the fungal infection generally progresses to chronic dissemination. Mucosal signs are frequent in this form but are rare in case of cutaneous histoplasmosis. Itraconazole (200 mg/d) is indicated for 6 months.

Alcoholism↗
PubMed1998

[Bullous erythema nodosum leprosum. A case report in French Guiana].

BACKGROUND: Polar and borderline lepromatosis leprosy can be complicated by type 2 reactional states, including erythema nodosum leprosum. CASE REPORT: A 36-year-old man was treated for lepromatous leprosum. He consulted for recurrent erythema nodosum leprosum. Certain nodular lesions were bullous. Histopathology demonstrated major dermal edema causing bullous blisters. Treatment with thalidomide led to rapid regression. DISCUSSION: The bullous form of erythema nodosum leprosum is rarely described in the literature. It raises the diffential diagnosis with other bullous dermatoses, particularly Sweet's syndrome.

Adult↗
PubMed1998

[Poisonous caterpillars in French Guyana. 5 cases].

BACKGROUND: Certain caterpillars produce venomous substances and cases of human envenomation are regularly published. CASE REPORTS: We report 5 cases of caterpillar-induced envenomation observed in French Guyana. The caterpillar bites produced variable clinical manifestations. Automeris liberia provoked acute pain and skin necrosis: Dirphia tarquinia, erythema; Hylesia, persistent erythematous plaque (4 days); Megalopyge, erythematous and edematous lesions at the site of the bite and distant skin lesions; Automeris, syncopal pain and edematous infiltration of the thigh lasting several days. DISCUSSION: Caterpillar envenomation necessitates consultation, emergency unit care, or even hospitalization. It is important to identify the causal caterpillar species in case of envenomation in order to evaluate risk. Lonomia achelous must always be suspected because this species can cause major fibrinogenolysis.

Adult↗
PubMed1998

[Impetigo in French Guyana. A clinical, bacteriological, toxicological and sensitivity to antibiotics study].

OBJECTIVE: We evaluated pertinent features of impetigo in French Guyana due to the increasing number of therapeutic failures with macrolides and fusidic acid. PATIENTS AND METHODS: A prospective study study was conducted over a 14-month period in the dermatology unit of the Cayenne hospital. Two groups of patients were identified: group 1 included patients with impetigo and group 2 patients with infected skin reactions. Epidemiological, bacteriological, toxinological (exofoliatines, leukocidine) and antibiotic data were recorded. RESULTS: Forty-one patients with impetigo and 31 patients with infected skin reactions were included. Staphylococcus infection alone was identified in most patients (68 p. 100) in the impetigo group. Exfoliatine-producing strains were strongly associated with Staphylococcus-induced bullous and non-bullous impetigo (93 p. 100) compared with other origins (impetigo with streptococcal infection or infected skin reactions). Resistance to macrolides was high (erythromycin 41 p. 100, fusidic acid 42 p. 100) for all isolated strains of Staphylococcus aureus. CONCLUSION: A sub-group of patients with impetigo was identified. These patients had pure staphylococcal infections characterized by strong association with exfoliatine production. The rate of resistance to macrolides was particularly high in this sub-group. Resistance to fusidic acid was high for all Staphylococcus strains isolated.

Adolescent↗
PubMed1997

[Rapid diagnosis of cutaneous leishmaniasis and histoplasmosis by direct microscopic tests].

BACKGROUND: Cutaneous leishmaniasis and disseminated histoplasmosis can be diagnosed by direct examination of pathology specimens after Giemsa staining. CASE REPORT: An HIV-infected man developed cutaneous leishmaniasis and disseminated histoplasmosis with buccal lesions concomitantly. Smears stained with the RAL 555 kit provided the diagnosis of these two diseases. DISCUSSION: This case illustrates how direct microscopic examinations can provide inexpensive, rapid and safe diagnosis of infectious diseases. Direct microscopic examinations are routine practice in a tropical dermatology unit.

Cytodiagnosis↗
PubMed1997

[Staphylococcus aureus septicemia producing Panton-Valentine leukocidin. 3 cases].

BACKGROUND: A strong association has been observed between furuncles and Panton-Valentine leukocidin-producing Staphylococcus aureus. CASE REPORTS: Within one year, we cared for three men at the Cayenne hospital who had Staphylococcus aureus septicemia with severe pleuropulmonary involvement originating from furuncular lesions. The Staphylococcus aureus strains isolated from the skin lesions and from blood cultures produced Panton-Valentine leukocidin. CONCLUSION: These cases demonstrate the gravity of S. aureus septicemia in young patients with furunculosis. These cases are the first reported with severe S. aureus infections associated with Panton-Valentine leukocidin producing strains.

Adolescent↗
PubMed1996

[Leishmania (Viannia) braziliensis Vianna, 1911 in French Guiana. Clinical, therapeutic and epidemiological considerations in the ninth human diagnosed case].

The authors report the ninth case of cutaneous Leishmaniasis without mucosal involvement due to Leishmania (Viannia) braziliensis (isoenzymatic profile related to zymodeme MON-44) diagnosed in a legionnaire who recently arrived in French Guiana. The skin lesion as a single ulcerated nodule of the dorsum of the left ringfinger was cured after two courses of four intramuscular injections of pentamidine isothionate (total posology of pentamidine-base: 16.6 mg/kg). The transmission occurred during nocturnal trekking in forest and swamps just behind the coastal belt at Degrad Saramaka (7 km South of Kourou). In French Guiana, the good level of medical care and the early treatment of the majority of the cases of Leishmaniasis may explain the rarity of mucosal lesions. Since the clinical aspect of the lesion is not sufficient to prejudge the identity of the causative species, it is necessary to perform cultivation of Leishmania for iso-enzymatic identification. The adaptation of pentamidine doses and long term follow up of patients infected by L. (V.) braziliensis could be defined more precisely.

Adult↗
PubMed1995

[Disseminated histoplasmosis: 2 cases in patients with human immunodeficiency virus infection in French Guiana].

The authors report two cases of disseminated histoplasmosis occurring in HIV-infected patients living in French Guiana. The first case was an acute disseminated histoplasmosis with a rapid fatal evolution. The second case was diagnosed on a mucosal localisation, and improved under itraconazole therapy. These two cases show the diversity of the clinical course of this opportunistic infection. The authors focus on the difficulty of the diagnosis and the need for direct microscopic examination to identify histoplasma and to enable a swift therapeutic intervention.

AIDS-Related Opportunistic Infections↗
PubMed1993

Granulomatous reaction and tissue remodelling in the cutaneous lesion of chromomycosis.

The cell-mediated immune reaction was studied in the cutaneous lesion of chromomycosis, using monoclonal antibodies against polymorphonuclear neutrophils, macrophage and lymphocyte subsets, endothelial and fibroblast cells. In addition, immunostaining of the main degradative enzymes (neutrophil elastase and interstitial collagenase) and certain important cytokines (transforming growth factor-beta, tumour necrosis factor-alpha and interferon-gamma) suggested an explanation for the granulomatous reaction and the associated tissue remodelling. The distribution pattern of neutrophils and macrophage subsets, observed by computer-aided image analysis, suggests that the in situ persistence of fungi is the main pathological factor.

Antigens, CD↗
PubMed1993

[Prurigo in tropical area. Importance of its association with HIV infection].

The term prurigo applies to a classic chronic skin disease of children (P. strophulus) which is becoming found very seldom in developed countries, but remains extraordinarily prevalent in tropical areas. This striking geographical distribution relies on its ectoparasitic origin. Some peculiar aspects of prurigo, observed in French Guyana (South America), are reported. The original point is a new aspect of adult acquired prurigo, associated with HIV infection, which appears to be one of the features characteristic of tropical AIDS. This HIV associated prurigo (HAP) is the revelating event, in as high as 20% of HIV infected people, significatively those with less than 200 CD4 cells. HAP appears as a marker of HIV infection with poor sensitivity, but much higher specificity (92%), with no correlation with acquisition's risk factors. Just like infantile prurigo, HAP can be considered an arthropod bite reaction which seems to be enhanced in HIV infected people living in tropical environment.

CD4 Lymphocyte Count↗
PubMed1992

Cell-matrix patterns in the cutaneous lesion of chromomycosis.

Chromomycosis is a chronic fungal infection characterized by dermal fibrosis with persisting fungi in situ, generally leading to a verrucous skin lesion. The absence of good clinical results under specific treatment suggests irreversibility of the fibrotic lesion. Frozen and paraffin-embedded skin biopsies of eleven patients with chromomycosis due to Phialophora pedrosoi were studied by immunohistochemistry and electron microscopy. Distinct cell-matrix patterns were found in different tissue localizations: neutrophilic abscesses with oedema and necrotic keratinocytes in the epidermis; dense connective matrix around inflammatory infiltrates, mainly composed of macrophages and giant cells, and organized granuloma in the dermis. Active fibroblasts and mast cells were constantly observed. The inability of fibrotic tissue to be remodelled seems correlated to the nature and the organization of the matrix components but, the factors triggering the initial fibrogenic events remain to be characterized.

Adult↗
PubMed1984

[Prevention of postoperative anaerobic infections. Economic significance of metronidazole suppositories].

Metronidazole is widely used in the preventive and curative treatment of post-operative anaerobic infections. As the intravenous form is very expensive, a 1 g suppository has been developed. The pharmacokinetics of metronidazole injection and suppository was studied comparatively in 10 healthy subjects. The serum bioavailability of the rectal form was 80% with a peak serum concentration of 10 mg/l four hours after dosing. From calculated pharmacokinetic values it may be suggested that: (1) in cases of elective surgery treatment could begin with the rectal form alone at the rate of one suppository 12-hourly, starting 48 hours before surgery; (2) in emergency surgery, 0,5g of metronidazole i.v. over 20 minutes and a 1 g suppository should be administered at the time of premedication, treatment being continued with one suppository 12-hourly; (3) in patients at high risk of anaerobic infection, one suppository should be given 8-hourly, starting 24 hours before surgery. The main advantage of the rectal treatment is that it is much cheaper than the intravenous treatment administered during the same period.

Adult↗
PubMedDate not supplied

[Infection by the human immunodeficiency virus (HIV) in French Guyana. Dermato-venereologic problems].

Dermato-venereal manifestations in HIV infection and its severe evolution stage, AIDS, is of particular importance in tropical zones: We may be suspicious of the viral infection and consequently to request serologic tests to confirm it. We get an explanation of the virus transmission during heterosexual relations by the frequent occurrence and importance of the genital manifestations, leading to consider AIDS as a true sexually transmitted disease. Beside the classical opportunistic infections, the authors draw the attention to three types of manifestations: prurigo, already well known in Haïti and Africa capillary dystrophies, already reported in Haïti donovanosis that, because its epidemiological and etiopathological peculiarities, should be listed within the possible opportunistic infection if we take into consideration the regional pathological environment. In an other correction, syphilis, lepra and cutaneous leishmaniasis have to be carefully monitored, because they are capable to evaluate unexpectedly in some immunodepressive diathesis. Importance of dermato-venereal pathology in black people in tropical zone is explained by the weakness of cutaneous corneal stratum, immunologic disorders linked up to accumulated parasitic pathologies, socio-cultural life with a sexuality without complex.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Human immunodeficiency virus (HIV) infection in mothers and infants in French Guyana. Epidemiologic study apropos of 44 women having conceived 55 children].

The French Guyana is an Overseas French Department in South America, with 100,000 inhabitants among them are 20% of Haitian immigrants. At 31 December 1987, 103 AIDS cases have been recorded, 86% by heterosexual transmission. The first case dated May 1979 was retroactively diagnosed in an Haitian parturient, thank to her serum kept in the Pasteur institute of Cayenne. 44 women got their pregnancy during their HIV infection: 5 with clinical and biological evidence of AIDS, 7 developed AIDS after getting pregnant, and 10 out of these 12 women died. All of them were from a rather low social group and, generally, were not married. 43 are black (40 Haitians and 3 Guyanese Creoles), one is Indian and presented some psychic disorders. The mean age was 32 1/2 (from 15 to 51 years old). 55 babies were born: 12 developed AIDS (6 died during the first 15 months of their life); 14 are HIV +, 3 stillborns, 4 never tested and 22 developed negative reaction (with ELISA and Western-Blot) between 7.5 and 10 months of their life. Two Hutchinson's triads were observed. Prurigo is the most commonly skin manifestation observed.

AIDS Serodiagnosis↗
PubMedDate not supplied

[Genital ulcers in French Guyana. Apropos of 231 cases screened in 2 years].

In fight against Sexually Transmitted Diseases (STD), 231 cases of genital ulcers were observed, in 1985 and 1986, in Cayenne (French Guiana) according to a clinical and laboratory study protocol described by the authors. The diagnosis shown, in 146 cases, one STD agent, with a high frequency of chancroid, herpes genitalis and primary syphilis. In addition, 18 cases of mixed genital infections are described: emphasis is laid on the great diversity of these associated diseases. 67 genital ulcers had not been caused by a STD agent, however in each case a complete laboratory investigation was done, and each patient received a treatment according to the diagnosis.

Adolescent↗