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Biomedical subjects

F Vachon

Publications and source records attributed to F Vachon.

At least 91 records · Page 5Linked to original sources
PubMed1983

[Treatment of enterobacterial meningitis in adults with intravenous lamoxactam].

Meningitis caused by Gram-negative bacilli creates difficult problems since most strains are multiresistant. The purpose of this study was to evaluate the effectiveness of lamoxactam administered intravenously. Eleven patients admitted to an intensive care unit with meningitis due to Gram-negative bacilli were treated with this antibiotic, administered alone in 9 cases. Three patients had ventriculitis. Eight survived. The MICs ranged from 0.06 to 0.5 microgram/ml in 10 cases. The CSF was sterilized and rapidly became normal. Meningeal concentrations varied from 1-5 to 62 micrograms/ml and the CSF was bactericidal. In one female patient the CSF was sterile on the 5th day of treatment but remained abnormal; the meningeal concentration of lamoxactam (35 micrograms/ml) was much higher than the MIC (2 micrograms/ml) but below the MBC (128 micrograms/ml), which was consistent with the absence of bactericidal effect of the CSF. Owing to its very low CMIs and satisfactory passage through the blood-brain barrier, lamoxactam administered alone can be successful in the treatment of Gram-negative meningitis and ventriculitis. However, the bactericidal effect of the CSF should be rapidly assessed.

Adult↗
PubMed1982

Severe meningitis due to Listeria monocytogenes. A review of 40 cases in adults.

During a 10-yr period, 40 cases of severe Listeria monocytogenes meningitis were observed. All patients showed consciousness disturbances and 27 of them (68%) focal neurologic signs. Cranial nerve palsies were common (57%). Early general seizures (13 patients) and presence of underlying disease (12 patients) were associated with a high mortality rate. Although the management of antibiotic therapy is open for discussion, chloramphenicol (used in 7 patients) seems to be more effective than other drugs.

Adult↗
PubMed1982

[Gram negative bacilli endocarditis ].

Gram negative bacilli endocarditis are unfrequent. Nevertheless we encountered 28 cases of them (8.8%) among 320 endocarditis of which 10 were primitive and 7 cases (10.9%) among 65 prosthetic endocarditis. Bacterial species were 12 Pseudomonas aeruginosa, 2 Ps, stutzeri, 1 Ps. maltophilia, 2 Klebsiella pneumoniae, 2 Escherichia coli, 3 Serratia marcescans, 1 Enterobacter cloacae, 1 Brucella, 1 Hemophilus aphrophilus, 1 Fusobacterium funduliformis, 18 cases were hospital acquired infections related to cardiac surgery (4 cases), intracardiac catheterization (5 cases), intravenous catheter (4 cases). Uncontrolled infection or cardiac insufficiency underwent respectively in 14 and 18 cases. The overall mortality was 50 p. cent. The death occurred more frequently in primitive endocarditis (70%) than in secondary native endocarditis (45%) or prosthetic endocarditis (29%). It was also more frequent in Pseudomonas endocarditis (59%) than with other species (36%) and more frequent when cardiac sufficiency was present (50%). 15 patients underwent surgical procedure of which 6 died (40%). The results were better if the infection was cured before surgical procedures: 5 deaths occurred when the culture of the valves remained positive (9 cases) but none when it was negative. The 5 most recent cases of prosthetic endocarditis were cured. Since 1979, no death occurred among treated patients. we concluded that surgery is usually necessary but after an effective antibiotic therapy over a 4 or 6 week period.

Adolescent↗
PubMed1982

[Psittacosis as a cause of acute respiratory distress syndrome (author's transl)].

Diagnosis of acute, primary extensive pneumopathies provoking severe hypoxemia is particularly difficult, became of the non-specific radiological findings, resulting from the oedema and associated alveolar collapse, and the fact that the clinical picture and biological test results are not very characteristic of a particular etiology. Similar findings may be obtained, therefore, in bacterial pneumopathies so-called typical pulmonary affections, certain forms of acute, tuberculosis, and other types of infection of three patients admitted for acute respiratory insufficiency, two died after treatment with a betalactamine, alone or associated with an aminoside, subsequent serology providing evidence of psittacosis. Diagnosis was immediately established in the third patient, the wife of one of the other cases, and she recovered after erythromycin treatment. The lungs of the two patients that died showed suggestive bronchiolitis and peribronchiolar alveolitis, together with obliterative alveolar granulations and fibrosis, probably secondary to the psittacosis, and responsible for the fatal outcome. Psittacosis as a cause of an extensive pneumopathy of probable infectious origin may easily pass unrecognized, typical etiologies being infections due to pneumococcus, Legionella pneumophila. Mycoplasma pneumoniae, and viruses. Erythromycin, active against these microorganisms, would therefore appear to be the antibiotic therapy that should be prescribed initially, those with wider spectrums being reserved for cases with atypical radiological findings, or when precise bacteriological data is available.

Adult↗
PubMed1982

[Cellulitis of the neck due to anaerobic germs: report of 10 cases (author's transl)].

Cellulitis of the neck in 10 patients was found to be due to anaerobic germ infections of either dental or tonsillar origins or following surgery. The lesion was diffuse in 8 cases, unilateral in two, and associated with signs of severe toxic infection in 9 cases. Early clinical crepitation was detected in 4 patients. The extremely poor prognosis related to the onset of infective shock and pleuropulmonary and mediastind complications, treatment including intensive care and anti-anaerobic germ antibiotic therapy. The place of surgical treatment is discussed, operative intervention being necessary when there are signs of poor general tolerance, not only in the presence of gas gangrene, but also when a diffuse cellulitis exists without signs of crepitation or the presence of fluid.

Anaerobiosis↗
PubMed1982

[Pneumococcal meningitis and ENT infections. Review of 100 cases (author's transl)].

One hundred cases of pneumococcal meningitis admitted to the Intensive Care Unit of the Infectious Diseases Department of the Hôpital Claude-Bernard, France are reviewed, and the course of this serious affection in this series described. Mortality was 38 p. cent as against that reported by INSERM of 45 p. cent. The original lesion was an ENT infection in 50 p. cent of cases, raising the problem of the need for early surgical intervention, on an otological focus which may appear minimal on otoscopic examination, when the meningitis does not respond to antibiotics.

Adolescent↗
PubMed1982

[Bacterial endocarditis on a mitral prosthesis with negative blood cultures. Case evolving over a 3 year period in the absence of fever].

A 38 year-old man, operated upon two years previously for combined mitral and tricuspid valve disease of rheumatic origin, presented with signs of a severe biological inflammatory syndrome, and a mild proliferative glomerulonephritis (normal complement with exclusively mesangial deposits of IgM, Clq, and C3 on immunofluorescence), which developed slowly over a period of 3 years in the absence of any fever. Blood cultures were always negative, and prolonged antibiotic therapy on two occasions had no effect on the clinical or biological picture. Mitral prosthesis replacement was necessary 6 months after the onset of the affection, a second leakage 16 months later leading to rapidly fatal heart failure. Pathological examination confirmed the presence of an endocarditis at the zone of insertion of the prosthesis. The slow progression of the disorder in this case, and the absence of fever, emphasize diagnostic difficulties of certain cases of endocarditis, due to low virulence germs, that progress under cover of a generalized disease of renal expression. The value of renal biopsy, which provided almost specific indications in the present case, is also stressed.

Adult↗
PubMed1981

[Bacterial endocarditis in drug addicts. 20 cases (author's transl)].

The authors report on 20 cases of bacterial endocarditis in heroin addicts, i.e. 9.1% of all cases of that infection observed over an 8-year period. The disease involved the tricuspid valve in 80% of the cases and was due to Staphylococcus aureus in the same percentage of patients. Diagnosis was sometimes difficult in the right heart but was confirmed by repeated echocardiography. Combined antibiotic therapy was administered for 45 days. Only one patient died of relapsing endocarditis on valve prosthesis. Six patients were operated upon: 2 for cardiac failure, 2 for persistent infection and 2 for recurrent pulmonary embolism. Three patients underwent valve replacement and 3 tricuspidectomy. The persistence of pulmonary embolism after eradication of the infecting organism does not seem to warrant surgery.

Adult↗
PubMed1981

Anti-erythrocyte autoimmunisation during chronic falciparum malaria.

Anaemia during malaria is not completely understood. Fourteen cases of antierythrocyte autoimmunisation with anti-I specificity were investigated in a Paris hospital during a period of 2 years. The patients lived in Gabon and had not been taking antimalarial chemoprophylaxis. All had chronic malaria (strongly positive antimalarial immunofluorescent antibody tests). All the recognised caused for anti-erythrocyte autoimmunity were excluded. One possible explanation for these observations is some sort of interaction between I antigen and Plasmodium, the result of which facilitated penetration of the erythrocyte by the malarial parasite.

Adolescent↗