[The syphilis].
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Biomedical subjects
Publications and source records attributed to J De Maubeuge.
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A case of early congenital syphilis is reported in order to emphasize that syphilis is still present nowadays and that detection of syphilis in pregnant women is primordial for the prevention of this disease.
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Tinea capitis is rare in adults, although a few cases have been described in HIV-infected patients. We present two cases in black African adults who were HIV positive. In one, the condition led to the diagnosis of HIV infection. It is possible that the rarity of tinea capitis in HIV-positive adults could be related to increased colonization of their scalp by Pityrosporum (Malassezia) spp. In patients well controlled with an antiviral therapy, the treatment of tinea capitis seems no more difficult than in non-immunosuppressed patients. There is possibly a relation between clinical presentation and degree of immunodeficiency.
OBJECTIVE: To compare the efficacy and safety of oral acyclovir (400 mg twice daily) with oral isoprinosine (500 mg twice daily) in the suppression of recurrent genital herpes. DESIGN: Double-blind, double-dummy, randomised, controlled, parallel group trial. SETTING: 13 centres in UK, Belgium and Germany. SUBJECTS: 127 immunocompetent patients with frequently recurring genital herpes. MAIN OUTCOME MEASURES: Proportions of patients reporting recurrences, recurrence frequency, and mean duration of lesions during breakthrough recurrences in each treatment group during a 6 month treatment period; time to first recurrence during treatment and follow-up after treatment cessation. RESULTS: During treatment, acyclovir recipients showed significant differences (p < 0.05) when compared with isoprinosine recipients in terms of a lower proportion reporting recurrences (31% vs 96%), a reduced mean number of reported recurrences per patient (0.6 vs 3.6), a shorter mean duration of breakthrough lesions (6.4 days vs 8.2 days), and a longer mean time (standard error) to first recurrence (143.7 (9.1) days vs 40.5 (5.4) days. The mean time to first recurrence after treatment cessation did not differ between the two groups. As compared with placebo recipients, isoprinosine treated patients had an increased recurrence frequency (3.6 vs 2.5) during treatment, and a shorter time to first recurrence after treatment cessation. All treatments were well tolerated without serious adverse events or toxicity. CONCLUSIONS: Acyclovir is very effective in suppressing recurrent genital herpes and is clearly superior to isoprinosine which is not clinically useful in the dosage studied.
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The clinically uninvolved skin of 4 patients with well-developed AIDS was investigated by electron microscopy. All biopsy specimens had vascular abnormalities: protruding endothelial cells, vascular channels reduced to slits, gaps within the vascular walls, and extravasated erythrocytes. These features are similar to those described in early lesions of Kaposi's sarcoma. These findings suggest that blood vessels of the clinically uninvolved skin of AIDS patients are potential sites of Kaposi's sarcoma lesions.
A 34-year-old African patient with AIDS developed a new form of oral leucoplakia closely resembling the "hairy" leucoplakia described by Greenspan in male homosexuals in the San Francisco area. A herpes-like virus was seen on ultrastructural analysis with electron microscopy. This case supplies further evidence suggesting that the syndrome in patients originating in Central Africa is similar to the acquired immunodeficiency syndrome (AIDS) reported in American patients.
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Monoclonal antibodies were used to determine the level of circulating helper and suppressor T cells in 34 infants and adults with severe atopic dermatitis and in normal controls. The percentage of OKT3 (total T lymphocytes) was reduced significantly in all the atopic infants. The percentage of OKT8 (suppressor-cytotoxic T lymphocytes) was reduced significantly in all patients with active lesions. The percentage of T gamma lymphocytes was reduced in all the atopic patients with or without active lesions.
The authors present 2 cases of AIDS revealed by severe recurrent genital herpes simplex. The patients are 2 young, previously healthy, African women without histories of homosexuality or drug abuse. The first patient died after 5 months of follow-up (post mortem findings: viral bronchopneumonia with positive cultures for herpes and cytomegalovirus (CMV), viral colitis due to CMV). The second patient survived. She has been treated, during the last 11 months, for filariasis, buccal and vaginal candidiasis and cerebral toxoplasmosis.
A case of cat-scratch syndrome is described. The dermatological features and skin reactions reported in this illness (erythema nodosum, erythema multiforma) as well as the diagnostical criteria are reviewed. The hypothetical nature of the etiologic agent of this syndrome is discussed.
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Aspergillus, which has a saprophytic life, is an opportunistic fungus and manifests his pathogenicity when a weakened state of the host facilitates its development. The conditions are particularly favorable in severely burned patients like the 54-year-old woman presented here. The criteria of pathogenicity of this opportunistic fungus, the incidence of epidemiology and prognosis of this type of infection and the clinical signs that allow an early diagnosis are discussed here.
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