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E Caumes

Publications and source records attributed to E Caumes.

At least 37 records · Page 2Linked to original sources
PubMed2003

[Lymph-node tuberculosis in patients infected or not with HIV: general characteristics, clinical presentation, microbiological diagnosis and treatment].

Lymph node tuberculosis is the most frequent form of extrapulmonary tuberculosis, especially in immunocompromised patients. We have studied patients with proven lymph node tuberculosis in the Department of Infectious Diseases at Pitié-Salpêtrière Hospital, Paris, between January 1997 and January 2002. Clinical presentation, microbiological diagnosis and treatment were analyzed in 13 HIV infected and 19 non-HIV infected patients. A risk factor for tuberculosis was present in all cases (HIV infection, immigration, life in community, poverty, past history of tuberculosis and IVDU). The median duration between the onset of symptoms and diagnosis was longer for HIV infected (2 months) compared with non-HIV infected patients (1 month). At the time of the diagnosis, general symptoms were present in >50% of patients of both groups. In HIV infected patients, abdominal lymph node involvement was more frequent (P < 0.05). All the non-HIV infected and 85% of HIV infected patients had peripheral adenopathies. A pulmonary tuberculosis was noted in more than half of the cases (53% non-HIV and 69% HIV patients). Inflammatory parameters and liver function tests were frequently abnormal in both groups. Hyponatremia was more frequent in HIV patients (P < 0.05). TB skin testing was more frequently positive and phlyctenular in non-HIV infected patients (P < 0.05). In this study, direct examination of the needle aspirate from infected lymph nodes was rarely positive; cultures were more frequently positive after biopsy compared to needle-aspiration. The median duration of treatment was 9 months for the two groups (6-24 months). Three HIV infected patients were infected by mycobacteria resistant to at least one antibiotic (isoniazid, 1; rifampicin, 1; isoniazid, streptomycin, etambutool, 1). All the patients recovered.

AIDS-Related Opportunistic Infections↗
PubMed2003

Failure of an ointment based on IR3535 (ethyl butylacetylaminopropionate) to prevent an outbreak of cercarial dermatitis during swimming races across Lake Annecy, France.

Cercarial dermatitis, a re-emerging disease world-wide, may affect those engaged in water sports. Many of those who swim in the annual cross-lake races at Annecy in France, for example, develop such dermatitis. In an attempt to see whether ethyl butylacetylaminopropionate (IR3535) would protect swimmers from the dermatitis, the exposed skin on the right side of each of 78 participants in the cross-lake races of 2001 was treated with IR3535-based ointment. When contacted by telephone during the week following the races, 64 (82%) of the subjects reported that they had developed cercarial dermatitis. Subjects with a past history of cercarial dermatitis were more likely to report an attack in 2001 than those who said that they had never had such dermatitis prior to 2001 (P=0.001). The skin lesions were scattered all over the body in 89% of the cases and limited to the left side of the body in 11%. Of the 63 cases who reported time of onset, 32 (51%) had noticed lesions within an hour of the race. The mean duration of clinical manifestations was 4.8 days (range=30 min-18 days). The clinical manifestations were significantly more severe in the subjects aged >16 years than in the younger subjects, although these two age-groups swam in separate races. Thirty-one of the affected subjects attempted to cure their dermatitis, using any of five different treatments. Overall, the results were disappointing, with the IR3535-based ointment, which had initially been developed as an insect repellent, appearing to offer little, if any, protection against cercarial dermatitis.

Adolescent↗
PubMed2003

[Clinical forms of the cutaneous tuberculosis].

Since Laennec's description of the "prosector's wart" in 1826, science has made great strides forward. The cutaneous forms of the infection with Mycobacterium tuberculosis are various. The most common clinical forms of cutaneous tuberculosis are lupus vulgaris and scrofuloderma. The clinical forms of cutaneous tuberculosis are usually classified according to the patient's immune status, and the way through which the skin has been infected. Nonetheless, as in leprosy, a classification based on the importance of the bacterial inoculum in situ is possible. Subsequently the diagnosis should be considered as easy in the multibacillary forms and much more difficult in the paucibacillary forms. In the former, the diagnosis should rely on bacteriological data. In the latter, the diagnosis will rely on the association of epidemiological, clinical and histological data whereas genomic amplification with PCR may be of potential interest.

Humans↗
PubMed2003

[Skin complications of stonefish envenomation in 6 travellers returning from the Indo-Pacific maritime region].

Stonefish (Synanceja verrucosa) sting has been known for a long time to be a medical hazard. It is a common cause of severe marine envenomation. Immediate complications (collapsus, pulmonary oedema) have been described extensively. Late complications (oedema, tissue necrosis) have not been studied in details although they are common and a cause of invalidity and pain. We have observed six travellers with complications of stonefish sting over a 10 year-period in our department. All the patients were coming back from the Indo-Pacific maritime region. They presented with cutaneous abcess (in one) or necrotic complications (foot ulcers in two, cellulitis in three) associated with painfull oedema in two and lymphangitis in three. Surgery has been performed in four patients, two of them undergoing many operations. Two had long term sequelae. Such complications could be avoided. Appropriate initial treatment (i.e., neutralization of the venom by hot water, disinfection, antivenom and antibioprophylaxis) seems to be able to reduce late complications. Antivenom is indicated in severe systemic manifestations which are life threatening and in case of crucial pains. Prevention is the most important part of therapy and relies on appropriate information of the travellers.

Adult↗
PubMed2002

[Legionellosis in HIV-1 infected patients. 4 case reports].

INTRODUCTION: Contrary to patients exhibiting cellular immunodepression, legionellosis is rare in HIV-infected patients. We report 4 cases. OBSERVATIONS: Four men aged 41 to 48 were infected by HIV-1. Three of them were treated with antiretroviral therapy. The clinical and biological manifestations were unspecific. Evolution was favourable with adapted antibiotic therapy (erythromycine for three patients and ciprofloxacine for the fourth). COMMENTS: Legionella pneumophila serotype Lp1 remains the principle etiological agent. Frequent use of contrimoxazole in prophylaxis against pneumocystosis and toxoplasmosis, macrolides, rifamycines and fluoroquinolones in the preventive and curative treatment of mycobacterioses, and the relative conservation of monocyte/macrophage function and immune repair with efficient antiretroviral therapy, may explain the low prevalence of this disease in HIV infections.

AIDS-Related Opportunistic Infections↗
PubMed2002

[Current clinical aspects of HIV/AIDS].

OF NEW CLINICAL DEMONSTRATIONS: Since the use of HAART, morbidity and mortality in HIV-infected patients have decreased dramatically. But increased survival in these patients is associated with other diseases (malignant diseases, inflammatory reactions after initiation of HAART) and with drug toxicity (lipodystrophy, mitochondrial toxicity). TRANSMISSION AND REVELATION: Despite widespread information on HIV, new HIV-infected patients with an AIDS-defining illness are still detected. At present, heterosexuality is the most frequent risk factor for HIV-infection (51%). Pneumocystis pneumonia remains the most common opportunistic illness in HIV-infected patients (28%).

AIDS-Related Opportunistic Infections↗
PubMed2002

Cutaneous larva migrans with folliculitis: report of seven cases and review of the literature.

Seven patients (four men, three women, mean age 31 years), all returning from the tropics, presented with pruritic folliculitis and creeping eruption. The folliculitis consisted of 20-100 follicular papules and pustules confined to a particular area of the body, mainly the buttocks. The creeping eruption consisted of two to 10 serpiginous or linear burrows 1-5 cm long located either in the same area or in a different area from the folliculitis. Five patients were cured with one to three courses of ivermectin (one course in two cases, two courses in two cases and three courses in one case) and two patients were cured with a 3-day regimen of albendazole. Folliculitis should be added to the dermatological manifestations of cutaneous larva migrans. Treatment is more difficult than in classical forms of cutaneous larva migrans.

Adult↗
PubMed2002

[Current data on malaria in metropolitan France].

Epidemiological data from the French National Reference Center for Imported Diseases showed that the estimated number of cases of imported malaria in France increased from 5,940 in 1998 to 7,127 in 1999 and 8,056 in 2000. This three-year progression ended in 2001 when the number of estimated cases fell back to 7,223. It was due mainly to the concomitant increase in the number of people traveling to endemic zones especially in Africa. In 2000 the median age of patients with imported malaria in France was 29.5 years and the sex ratio was 1.78. Sixty-three percent of cases involved people of African origin and 37% involved "Westerners". The countries in which contamination occurred were located in tropical Africa (95%), Asia (2.2%), and Latin America (2.7%). During the three year period from 1998 to 2000, there were a total of 13 accidental autochtonous cases of malaria involving patients with no history of travel to tropical areas. The distribution of Plasmodium species involved in imported malaria in France was stable with 83% of cases involving Plasmodium falciparum, 6% involving Plasmodium vivax, 6.5% involving Plasmodium ovale and 1.3% involving Plasmodium malariae. Attacks were clinically uncomplicated in 90 to 95% of cases and severe in 2 to 5% including fatal Plasmodium falciparum malaria in 0.49 to 0.37% of cases. Less than 10% of the 45% of patients claiming use of prophylaxis complied properly. Analysis of the drugs used for curative treatment in 2000 showed an increase in the use of quinine and mefloquine and decrease in the use of halofantrine. The main objectives remain reduction of mortality and improvement of prevention.

Adolescent↗
PubMed2001

Clinical and virologic characterization of acyclovir-resistant varicella-zoster viruses isolated from 11 patients with acquired immunodeficiency syndrome.

We studied the clinical resistance to acyclovir of infections with varicella-zoster viruses (VZV) in patients with acquired immunodeficiency syndrome, and we correlated it to virologic analyses. Eleven patients with VZV infections (treated with acyclovir, 30 mg/kg/day, given intravenously, or 4 g/day, given orally) were included in the study because of the failure of 10 days of acyclovir therapy. Susceptibility of VZV isolates to acyclovir was tested using a plaque reduction assay to determine the 50% inhibitory concentration (IC(50)) of acyclovir and the SI(50) (IC(50) of the patient isolate/IC(50) of the reference strain) to acyclovir. The thymidine kinase (TK) gene, which supports the resistance, was sequenced on amplified products. Only 3 patients had a significant increase in the IC(50), as compared with the IC(50) of the reference strain (SI(50) of > or =4), and a mutation in the TK gene. For the other 8 patients, the clinical resistance was not confirmed by the virologic results: the SI(50) was < 4, and no mutation was detected in the TK gene. Because no acyclovir-resistant strain appeared during a shorter period of time, we suggest an increase in the duration of the treatment to 21 days before acyclovir resistance is suspected.

Acyclovir↗
PubMed2001

Subacute clinical forms of Plasmodium falciparum malaria in travelers receiving chloroquine-proguanil prophylaxis.

We have observed 4 French travelers, returning from African countries, who were not immune to malaria and were receiving chloroquine-proguanil prophylaxis, in whom the diagnosis of malaria could easily have been missed because the clinical signs were uncommon. These cases suggest that chloroquine-proguanil prophylaxis is not always effective and that travelers with unexplained symptoms should be monitored closely for malaria.

Adult↗