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Biomedical subjects

E Caumes

Publications and source records attributed to E Caumes.

At least 91 records · Page 5Linked to original sources
PubMed1998

MR of cerebral malaria.

In three cases of cerebral malaria, MR imaging disclosed either cortical infarcts (one case) or hyperintense areas of white matter (two cases) on T2-weighted and fluid-attenuated inversion-recovery sequences. These white matter abnormalities were, in one case, sharply limited, symmetrical, hyperintense, and unenhanced; in the other case, they were diffuse, hyperintense, and had a more limited focus. The diffuse hyperintensity was probably due to edema, whereas focal lesions were probably associated with gliosis.

Adolescent↗
PubMed1998

Acyclovir-resistant varicella-zoster virus: phenotypic and genetic characterization.

A man with acquired immunodeficiency syndrome (AIDS) developed zoster of the right arm which was resistant clinically to acyclovir. Varicella-zoster virus (VZV) was cultured from a skin biopsy performed at the beginning of acyclovir therapy (isolate 1) and after its failure (isolate 2). The emergence of acyclovir resistance during treatment was investigated by developing a simple and rapid drug sensitivity assay based on the plaque reduction reference method. This late-antigen synthesis reduction assay involved serial dilutions of cell-associated virus. The 50% inhibitory concentration (IC50) of acyclovir was 16 +/- 7.5 microM for the susceptible reference strain OKA, in agreement with published data. The acyclovir IC50 increased from 6.5 microM for isolate 1 to 100 microM for isolate 2. In comparison with the sequence of isolate 1, isolate 2 had a single mutation consisting of a C to T change at position 907 of the thymidine kinase gene, which changed a glutamine codon into a stop codon at position 303 of the thymidine kinase protein. These results show the emergence of acyclovir resistance through a single previously undescribed mutation in the thymidine kinase gene, and confirm the heterogeneity of mutations inducing acyclovir resistance.

AIDS-Related Opportunistic Infections↗
PubMed1998

[Streptomyces somaliensis mycetoma with craniofacial involvement].

Mycetoma is a chronic granulomatous infection of the skin from which grains of the causative organism are eliminated via the sinus tracts. We report a rare case of cephalic mycetoma, which presented with an extensive involvement of the skull vault, base and an extradural granuloma. The diagnosis and treatment of the disease are discussed.

Bone Diseases↗
PubMed1997

[Tuberculous meningitis: clinical, biological and x-ray computed tomographic comparison between patients with or without HIV infection].

OBJECTIVES: Determine possible differences in clinical manifestations, laboratory findings and neuroimaging results in tuberculous meningitis patients with and without HIV infection. PATIENTS AND METHODS: We retrospectively reviewed data of 38 patients with positive cerebrospinal fluid cultures for Mycobacterium tuberculosis who were hospitalized in 3 university hospitals in Paris over the last 11 years. RESULTS: There were 24 HIV-infected patients and 14 without HIV infection. Mean CD4 lymphocyte count was 103 +/- 180/mm3 in the HIV group. Age (median age = 33 years for the HIV group vs. 53 for the non-HIV group), sex ratio (3 vs. 0.75), and prior history of tuberculosis (46% vs. 43%) were similar in both groups. Clinical presentation was similar for headache (83% in HIV group vs. 50% in non-HIV group; p = 0.02) and confusion (54% vs. 93% in non-HIV group p = 0.05). Serum natremia (mmol/l) (131 +/- 5 vs. 125 +/- 8; p = 0.024), white blood cell count (x 10(9)/l) (5.8 +/- 4.7 vs. 10.7 +/- 1.7; p = 0.37) and erythrocyte sedementation rate (mm/h) (68 +/- 34 vs. 31 +/- 35; p = 0.003) were significantly different in the 2 groups. Median cerebrospinal fluid findings were similar in the 2 groups: leukocytes (x 10(6)/l) (375 +/- 860 vs 218 +/- 250), glucose (mmol/l) (2.3 +/- 0.9 vs 2.7 +/- 1.9) and protein (g/l) (3.8 +/- 7.1 vs. 2.6 +/- 1.6). CT-scans of the brain were similar in the 2 groups. Mortality during hospitalization was similar (42% vs 36%; NS). CONCLUSION: HIV infection appears to have little impact on the presentation of tuberculous meningitis.

Adult↗
PubMed1997

Efficacy and safety of desensitization with sulfamethoxazole and trimethoprim in 48 previously hypersensitive patients infected with human immunodeficiency virus.

OBJECTIVE: To study the safety and efficacy of desensitization with the use of a combination product of sulfamethoxazole and trimethoprim in previously hypersensitive patients infected with the human immunodeficiency virus. DESIGN: Prospective survey, with a median follow-up of 16 months (range, 5-24 months). SETTING: Day-care hospital in a referral center. PATIENTS: All human immunodeficiency virus-infected patients who had a history of allergic reactions (eg, rash) to sulfamethoxazole-trimethoprim and who required sulfamethoxazole-trimethoprim prophylaxis. INTERVENTION: The desensitization procedure took 2 days. The full dose (sulfamethoxazole-trimethoprim, 400-80 mg) was reached on the third day according to the following schedule: day 1--4-0.8 mg at 9 AM, 8-1.6 mg at 11 AM, 20-4 mg at 1 PM, and 40-8 mg at 5 PM; day 2--80-16 mg at 9 AM, 160-32 mg at 3 PM, and 200-40 mg at 9 PM; and day 3--400-80 mg at 9 AM. MAIN OUTCOME MEASURE: The onset of cutaneous adverse effects attributable to sulfamethoxazole-trimethoprim therapy within 3 months after desensitization. RESULTS: Of the 48 evaluable patients, 37 (77%) tolerated sulfamethoxazole-trimethoprim desensitization without toxic effects and continued to take sulfamethoxazole-trimethoprim daily. Desensitization failed in 11 cases (5 on day 1, 3 on day 2, and 1 each on days 9, 11, and 90). Acute hypotension and a nonfatal myocardial infarction developed in 1 of these patients. The factors that were predictive of failure were a relatively high CD4+ cell percentage (11% vs 8%; P = .008) and a relatively high CD4+/CD8+ ratio (0.27 vs 0.12; P = .02). CONCLUSIONS: The efficacy of desensitization with sulfamethoxazole-trimethoprim was confirmed; this desensitization procedure was more often successful in patients with lower CD4+ cell percentages and CD4+/CD8+ ratios. However, sulfamethoxazole-trimethoprim therapy should be reintroduced carefully.

Adult↗
PubMed1997

[Value of desensitization for reintroducing trimethoprim-sulfamethoxazole in hypersensitive patients with HIV infection].

The incremental administration of trimethoprim-sulfamethoxazole (i.e., desensitization) in previously hypersensitive HIV-infected patients has been evaluated to date in 7 studies involving more than 10 patients. These studies differ greatly from one to another according to the inclusion criteria, exclusion criteria, and desensitization procedure (duration, lagtime between 2 doses). The efficacy varies from 33% to 100% but one can expect success in 3 out of 4 patients whatever the duration of the desensitization procedure. Short procedures seem better than long ones from the compliance point of view. These different procedures have not been compared each other. The reputation of good tolerance of this procedure is challenged by the recent description of severe life-threatening systemic reaction. Subsequent contra-indications must be ruled out and this procedure must be supervised in hospital.

Anti-Infective Agents↗
PubMed1997

[Prevention of herpes simplex and varicella zoster infections in patients of HIV infections].

Reactivation of Herpes simplex virus and varicella zoster virus infections occurs frequently in patients infected with human immunodeficiency virus (HIV). Prevention of Herpes simplex recurrences with oral acyclovir (400 mg x 2/day) should be recommended for patients with more than 6 relapses per year. Varicella-zoster immunoglobulin is recommended for prophylaxis of varicella in exposed HIV-infected adults and children who are susceptible. Prevention of varicella-zoster recurrences with oral acyclovir (800 mg x 5/day) should be considered for patients with retinopathy.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Ivermectin and tropical dermatoses].

Among tropical dermatoses, the main indications of ivermectine are tropical parasitoses such as filariasis and cosmopolitan diseases due to ectoparasites such as scabies. The efficacy and tolerance of ivermectine in filariasis (onchocerciasis, lymphatic filariasis, loiasis) have been the topic of numerous articles and reviews. More recent studies showed that ivermectin was also efficient in the therapy of scabies, cutaneous larva migrans and larva currens.

Antinematodal Agents↗
PubMed1997

[Apropos of 5 new cases of onchocerciasis edema].

We report 5 cases of onchocerciasis presenting as limb's swelling collected in the tropical disease unit of a parisian hospital between 1982 and 1993. They are 5 men which have lived between 3 weeks and 4 years in forested areas of Cameroon in four cases and Côte d'Ivoire in one case. The incubation period varied from 5 months to 2 years. The limb oedema was always located to one arm. It was associated with a blood eosinophilia above 2000/mm3 in 4 of 5 patients. The skin detection of microfilaria of Onchocerca volvulus was positive in every case. The serodiagnostic tests were negative for indirect immunoflurescent assay and immunoelectrophoresis with exception of one patient. These patients were cured with ivermectine and/or diethylcarbamazine. In addition, 26 other cases described in the literature are discussed.

Animals↗
PubMed1997

[Cutaneous tuberculosis. A study of 4 cases].

INTRODUCTION: The recent increase in the incidence of tuberculosis has led to the return of cutaneous forms of this disease. In addition, diagnosis can now be made rapidly using genoma amplification. CASE REPORT: Four cases of cutaneous tuberculosis are described in nonimmunosuppressed patients: two cases of lupus vulgaris, including one due to Mycobacterium africanum, and two others of gummas, including one associated with tuberculosis verrucosa. The diagnosis was suggested by epidemiological, clinical, histological and immunological findings and confirmed by culture of the bacilli in 3 cases and by genoma amplification in 1. DISCUSSION: These observations illustrate the difficulties encountered in determining the tuberculosis nature of skin lesions. The clinical presentation, differential diagnosis, the pathophysiology of this disease and the new interest in genoma amplification are discussed.

Adult↗
PubMed1996

[Cotrimoxazole induced dermatitis and curative treatment of AIDS pneumocystosis].

Adverse cutaneous reactions frequently occur during the treatment of AIDS associated pneumocystosis by trimethoprime-sulfamethoxazole. The most common form is a maculous rash. Treating throughout the duration of hypersensitivity may lead to potentially lethal Stevens-Johnson and Lyell syndromes. Slow acetylator phenotype, a glutathion deficiency and a history of adverse cutaneous reactions have been identified as risk factors of cutaneous reactions. An adjuvant corticosteroid therapy decreases the frequency of adverse cutaneous reactions during the treatment of hypoxaemic pneumocystosis by trimethoprim-sulfamethoxazole.

AIDS-Related Opportunistic Infections↗