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D Salmon-Ceron

Publications and source records attributed to D Salmon-Ceron.

25 records · Page 2Linked to original sources
PubMed1995

Lower survival in AIDS patients receiving dapsone compared with aerosolized pentamidine for secondary prophylaxis of Pneumocystis carinii pneumonia. Study Group.

A randomized, unblinded study compared aerosolized pentamidine, 300 mg every month, and dapsone, 50 mg/day, for secondary prophylaxis of pneumocystosis in 196 AIDS patients. The study was prematurely discontinued due to excess mortality in the dapsone group. After a mean follow-up of 13 +/- 6.4 months, 22 (21%) of 103 patients in the pentamidine group were dead compared with 39 (42%) of 93 receiving dapsone; the estimated mortality rates at 18 months were 24.6% and 53.1%, respectively (P < .003, log-rank test). A negative interaction was observed between zidovudine and dapsone (P < .049, interaction test of Cox model), and the mean CD4 cell count during the study was lower in the dapsone (49 +/- 61/mm3) than in the pentamidine group (83 +/- 88/mm3; P < .002, t test). The lower survival might also be related to the oxidative effect of dapsone or to the addition of iron protoxalate to dapsone in this study. These results suggest caution in using dapsone as long-term therapy in advanced human immunodeficiency virus infection, especially in those receiving zidovudine.

AIDS-Related Opportunistic Infections↗
PubMed1993

Invasive aspergillosis in patients with acquired immunodeficiency syndrome: report of 33 cases. French Cooperative Study Group on Aspergillosis in AIDS.

PURPOSE: Acquired immunodeficiency syndrome (AIDS)-associated invasive aspergillosis (IA) is a rare condition, which is mainly reported as isolated cases either antemortem or at autopsy. The role of AIDS itself is controversial, because many of the reported patients exhibited the classic risk factors such as neutropenia and steroid therapy. The aims of this study were to report 33 patients with IA during AIDS and their outcome, focusing on the risk factors and the value of diagnostic procedures. PATIENTS AND METHODS: Thirty-three patients from 17 different medical centers in France were retrospectively included in the study. For pulmonary IA, we defined two types of patients: those with "confirmed IA," describing all the patients with histologically proven disease, and those with "probable IA," who had the development of a new pulmonary infiltrate on chest radiograph and a positive bronchoalveolar lavage (BAL) fluid culture for Aspergillus species without identification of other pathogens. For extrapulmonary IA, the diagnostic criteria included both positive histology and culture. RESULTS: Of the 33 cases included in this series, 91% were recorded during the last 3 years (1989 to 1991), suggesting that aspergillosis is an emerging complication in AIDS. Approximately 50% of the patients did not exhibit any classic risk factor, i.e., neutropenia and steroid treatment; almost all patients had a CD4 cell count less than 50/mm3. The mycologic culture from BAL was the method of choice for the diagnosis of invasive pulmonary disease because it was known to correlate well with histologic findings obtained either antemortem or postmortem. Of 28 patients with a positive BAL culture for Aspergillus, 15 underwent a biopsy or autopsy and 14 were positive at histology. Serum antigen detection was positive in only 4 of 16 tested patients. Clinical and radiologic signs did not differ from those observed in neutropenic patients without human immunodeficiency virus, except for the higher incidence of neurologic complications in AIDS. Interestingly, we observed three cases of invasive necrotizing tracheobronchial aspergillosis with acute dyspnea and wheezing. The use of amphotericin B (0.5 mg/kg/d) and/or itraconazole (200 to 600 mg/d) was most often unsuccessful. Only four patients experienced clinical and radiologic improvement. The mean interval between the diagnosis of IA and death was 8 weeks (range: 3 days to 13 months). CONCLUSIONS: This study suggests that aspergillosis is an important life-threatening condition in the advanced stage of AIDS. It requires an early diagnosis with BAL fluid culture and careful therapeutic evaluation.

AIDS-Related Opportunistic Infections↗
PubMed1992

[Non-typhic Salmonella bacteremias in HIV infections. Clinical and therapeutic data, and course in 68 patients].

Between 1982 and 1989, a retrospective study on non typhi Salmonella bacteremias was performed among patients infected with human immunodeficiency virus hospitalized in 4 departments of Infectious and Tropical Diseases in Paris. The population included 59 men and 9 women; 26.4 percent had been contamined with HIV by heterosexual contact; 17.6 percent originated from Africa or Haiti. Clinical symptoms were fever (100 percent of the cases), present since less than 5 days (65 percent of the cases), and gastrointestinal symptoms, present in 53 percent of the patients. Blood cultures were positive in all cases; Salmonella was less frequently found in other sites: stools (n = 13, 19 percent), urine (n = 5), lymph nodes (n = 1), sputum (n = 1). Mean CD4 cell count was 118 +/- 145/mm3. The serotypes were mainly S. typhimurium (n = 26), S. enteritidis (n = 23), and S. dublin (n = 15). Under antibiotic therapy, the course of the disease was initially favorable in 98.5 percent of the cases. One patient died of septic shock. At least one relapse occurred in 17 percent of the patients, 2.1 +/- 1.6 months after the end of the initial therapy. No relapse was observed in patients taking zidovudine or antibioprophylaxis, but 53 percent of the patients without antibioprophylaxis relapsed (P less than 0.001). The overall survival of the cohort was 25 percent after 18 months. These results show the poor prognosis of a first episode of Salmonella bacteremia in HIV infected patients, making the diagnosis of AIDS highly probable if cellular immunity is markedly impaired.

4-Quinolones↗
PubMed1991

[Neuromeningeal Listeria infections in adults. Clinical, biological and therapeutic aspects. Apropos of 36 cases].

In this retrospective study, 36 cases of Listeria monocytogenes meningitis were reviewed. A bacteriological confirmation was obtained for every patient either by lombar puncture or blood culture. The clinical picture and the composition of the cerebrospinal fluid were polymorphous. Most patients were previously in good health, while 10 of them (28%) had a predisposing factor: pregnancy, gastrectomy, diabetes mellitus, alcoholism or immunosuppression. The outcome was favorable in 23 patients (64%); 8 patients were cured with sequelae (22%); 5 patients died (14%). Death occurred in patients suffering from concomitant underlying disease, such as coronary insufficiency (n = 1) or immunosuppression (n = 2), or in the case of delayed diagnosis and treatment (n = 2).

Adult↗