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Biomedical subjects

F Bruneel

Publications and source records attributed to F Bruneel.

At least 37 records · Page 2Linked to original sources
PubMed2000

Spondylodiscitis and epidural abscess due to Candida albicans.

A 32-year-old woman, addicted to heroin, presented with a dorsal spondylodiscitis due to Candida albicans associated with epidural abscess. Antimycotic treatment was successful, and no neurosurgical decompression was necessary. To our knowledge, this is the first case of documented epidural involvement in candidal spondylodiscitis. The diagnosis of candidal spondylodiscitis should be considered in cases of para- or tetraplegia occurring in intravenous drug abusers.

Adult↗
PubMed2000

Fatal invasive aspergillosis complicating severe Plasmodium falciparum malaria.

We report the first 2 cases of fatal invasive aspergillosis complicating severe malaria. In 2 nonimmune European adults without underlying disease, death was directly ascribable to invasive aspergillosis. We believe that transient malaria-induced immunosuppression allowed massive growth and overwhelming dissemination of preexisting Aspergillus colonization.

Adult↗
PubMed2000

Microbiological evaluation of central venous catheter administration hubs.

We compared, in three intensive care units, colonization of hubs with hub protection boxes or hubs with needleless closed connectors; 137 central venous catheters and 451 hubs were randomized in two groups with similar characteristics. Catheter and hub colonization were not different between the two groups. Among 30 colonized catheters, the same isolate was found in only two hubs; hub contamination rarely is responsible for catheter colonization in short-term catheters. Further studies are required to evaluate the benefit of protected hubs compared with unprotected hubs.

Bacteremia↗
PubMed2000

[Disseminated mucormycosis in AIDS].

Mucormycosis is a rare often fatal opportunistic condition. It mainly occurs in immunocompromised subjects but rarely in AIDS patients. An eighteen-year-old HIV+ man from Zaire died rapidly from disseminated mucormycosis with pulmonary, cardiac, renal, hepatic, splenic and gastric involvement. Fungi were observed in all these organs with a particular vascular trophism. Rhizopus orizae was identified on cultures. Rapid microscopic diagnosis, in the localized stage, could improve the poor prognosis of this infection.

AIDS-Related Opportunistic Infections↗
PubMed2000

[Intravenously administered gamma-globulins in reactive hemaphagocytic syndrome. Multicenter study to assess their importance, by the immunoglobulins group of experts of CEDIT of the AP-HP].

Reactive hemophagocytic syndrome is characterized by systemic proliferation and activation of benign hemophagocytic cells of the monocyte-macrophage lineage. Treatment should be directed to the etiology, but successful treatment with high-dose gamma-globulin has been reported, especially in viral-associated hemophagocytic syndrome. We report 17 patients, of which 9 had infection-associated hemophagocytic syndrome, all treated with high-dose gamma-globulin. High-dose gamma-globulins appear to be more effective in infection-associated hemophagocytic syndrome, with a mean dose of 1.6gm/kg for one or two cycles. A multicentric randomized study is required to evaluate high-dose gamma-globulin in the treatment of reactive hemophagocytic syndrome.

Adolescent↗
PubMed1999

Use of tunneled femoral catheters to prevent catheter-related infection. A randomized, controlled trial.

BACKGROUND: The risk for catheter-related infection seems higher with femoral catheters than with catheters inserted at other sites. OBJECTIVE: To evaluate the effect of catheter tunneling on femoral catheter-related infection in critically ill patients. DESIGN: Randomized, controlled trial. SETTING: Three intensive care units at academic hospitals in Paris, France. PATIENTS: 345 adult patients requiring a femoral venous catheter for more than 48 hours. INTERVENTION: Tunneled or nontunneled femoral catheters. MEASUREMENTS: Time to occurrence of systemic catheter-related sepsis, catheter-related bloodstream infection, and quantitative catheter tip culture with a cutoff of 10(3) colony-forming units/mL. RESULTS: Of 345 randomly assigned patients, 336 were evaluable. Probable systemic catheter-related sepsis occurred in 15 of 168 patients who received a nontunneled femoral catheter (controls) and in 5 of 168 patients who received a tunneled femoral catheter (estimated absolute risk reduction, 6% [95% CI, 0.9% to 11%]). Time to occurrence of catheter-related bloodstream infection was not significantly modified (relative risk, 0.28 [CI, 0.03 to 1.92]; P = 0.18); 3 events occurred in the control group and 1 event occurred in the tunneled-catheter group. After stratification by treatment center and adjustment for variables that were prognostic (use of broad-spectrum antimicrobial agents at catheter insertion) or imbalanced between both groups (mechanical ventilation at insertion), tunnelized catheterization reduced the proportion of patients who developed systemic catheter-related sepsis (relative risk, 0.25 [CI, 0.09 to 0.72]; P = 0.005) and positive quantitative culture of the catheter tip (relative risk, 0.48 [CI, 0.23 to 0.99]; P = 0.045). CONCLUSION: The incidence of femoral catheter-related infections in critically ill patients can be reduced by using subcutaneous tunneling.

Catheterization, Peripheral↗
PubMed1999

[Severe community-acquired bacterial pneumonia from Streptococcus pneumonia in HIV-infected patients: epidemiology and prognostic features of mortality].

In HIV-infected patients, community-acquired pneumonia due to Streptococcus pneumoniae is more common, more often associated with bacteremia, and more likely to recur. The epidemiology of this condition is discussed based on a literature review. Factors predictive of mortality in severe cases managed in intensive care units are analyzed.

AIDS-Related Opportunistic Infections↗
PubMed1998

Isolated right-sided Bartonella quintana endocarditis in an immunocompetent adult.

Bartonella quintana is a recently recognized cause of culture-negative left-sided endocarditis. We report a case of isolated tricuspid endocarditis caused by B. quintana in a 65-year-old alcoholic man, who also had immune-complex glomerulonephritis. B. quintana was established as the cause of the endocarditis based on serological tests and on failure of extensive efforts to isolate an alternative organism. The patient improved gradually on antibiotic therapy and did not require surgery. To our knowledge, this is the first report of isolated right-sided endocarditis caused by B. quintana. Although uncommon, Bartonella should be considered in patients with isolated right-sided culture-negative endocarditis.

Aged↗
PubMed1997

Shock complicating severe falciparum malaria in European adults.

OBJECTIVE: To study adult patients with severe falciparum malaria who developed shock. DESIGN: Retrospective study from 1987 to 1993. SETTING: Medical intensive care unit in a university hospital. PATIENTS: 14 patients admitted with severe falciparum malaria who developed shock. All received intravenous quinine. MEASUREMENTS AND RESULTS: The mean Simplified Acute Physiology Score II was 59.5 +/- 7.1; 2.6 +/- 0.4 criteria defining severe disease were present on admission in 12 patients; and initial parasitemia was 21 +/- 6%. Twelve patients received inotropic drugs. Pulmonary artery catheterization showed the following results in 7 patients: mean arterial pressure 57 +/- 4 mmHg; pulmonary artery occlusion pressure 11 +/- 1 mmHg; cardiac index 5.5 +/- 0.91.min-1.m-2, and systemic vascular resistance index 783 +/- 122 dyne.s.cm-5.m-2. Seven patients had evidence of bacterial infection at the time of shock. Of the 7 deaths (50%), 5 were due to shock, with documented bacterial infection in all patients and persistent parasitemia in 4. CONCLUSIONS: Shock complicating severe falciparum malaria in adults is associated with peripheral vasodilation and carries a poor prognosis. In falciparum malaria with shock, bacterial coinfection should be suspected immediately and treated empirically with broad-spectrum antibiotics. Nevertheless, Plasmodium falciparum may contribute directly or indirectly to the onset of shock.

Adult↗
PubMed1994

Fulminant hepatitis with severe lactate acidosis in HIV-infected patients on didanosine therapy.

We report two cases of fulminant hepatic failure in HIV-1-infected patients treated with didanosine (ddI). Clinical manifestations including vomiting, diarrhoea and dyspnoea were identical in both cases. Biological data mainly revealed hepatic failure and lactic acidosis. Histological examination of liver biopsies showed diffuse microvesicular steatosis. The outcome was fatal in both patients. The only comparable case previously reported (Lai et al., 1991) showed close similarities in the clinical, biological and histological manifestations with microvesicular steatosis. This prompted us to suspect that ddI might be responsible for fulminant hepatitis in all three AIDS patients. This toxic effect may be added to the list of potential adverse events occurring during ddI therapy.

AIDS-Related Opportunistic Infections↗
PubMed1992

[T CD57+ lymphocytes in kidney transplanted patients. Phenotypic and functional study].

Phenotypic analysis showed a significant increase of CD3+/CD57+ lymphocyte subpopulation in 88 kidney-transplanted patients when compared with non-transplanted patients. No clear correlation was found between the increase of this cell subpopulation and renal function, immunosuppressive regimen, and allogenic or viral stimuli, when each of these factors was considered. Conversely, there was a significant correlation between the proportion of CD3+/CD4+/CD57+ cells and the post-transplant follow-up period. Finally, functional study of CD3+/CD57+ cells suggested that they have suppressive properties, in vitro.

Antigens, CD↗