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Biomedical subjects

P Blanche

Publications and source records attributed to P Blanche.

At least 91 records · Page 5Linked to original sources

Pulmonary disease associated with the human immunodeficiency virus in Kigali, Rwanda. A fiberoptic bronchoscopic study of 111 cases of undetermined etiology.

All human immunodeficiency virus type 1 (HIV-1) infected adult patients referred to the Division of Pulmonary Diseases of the Centre Hospitalier de Kigali, Rwanda for evaluation of a pulmonary disease of undetermined etiology (PDUE) were investigated by fiberoptic bronchoscopy using both bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB). During a 10-mo period 111 HIV-1 infected patients with PDUE were examined, of whom 47 (42%) fulfilled the World Health Organization (WHO) clinical case definition for acquired immunodeficiency syndrome (AIDS) and seven (6%) had an AIDS-defining illness. Nonspecific interstitial pneumonitis was diagnosed in 42 (38%) patients, tuberculosis in 25 (23%), cryptococcosis in 14 (13%), Kaposi's sarcoma (KS) in 10 (9%), Pneumocystis carinii pneumonia (PCP) in five (5%). The diagnosis remained undetermined in 18 (16%) patients. Chest radiograph patterns were generally nonspecific. TBB and BAL had diagnostic yields of 82 and 26% of all final diagnoses, respectively. Our study on Rwandese HIV-1-infected patients with PDUE provides evidence for a large spectrum of pulmonary diseases with relative frequencies differing strikingly from those in developed countries. Detailed investigations confirm the rarity of PCP in Africa and highlight nonspecific interstitial pneumonitis as the predominant diagnosis of PDUE. Empiric antituberculosis treatment is justified in the absence of clinical manifestations suggestive of a specific diagnosis and while awaiting the results of the diagnostic procedures. Primary prophylaxis for PCP would not be appropriate in Africa.

Adult↗

[Does septic arthritis occur in human immunodeficiency virus infection?].

No prospective, longitudinal, cohort studies comparing septic arthritis in HIV-positive and HIV-negative individuals belonging to the various risk factor groups for HIV-infection are available. However, a review of the literature provided information on the main features of pyarthrosis in HIV-infected patients. The clinical and microbiological characteristics, as well as the outcome of this rare complication, vary with the risk factor group and with the severity of the immune deficiency. Pyogenic bacteria are the most common causative agents and should be looked for routinely since they usually respond well to antimicrobial therapy.

Arthritis, Infectious↗

Acute arthritis and human immunodeficiency virus infection in Rwanda.

OBJECTIVE: To determine the etiology of acute arthritis observed in adults and to define its relationship with human immunodeficiency virus 1 (HIV-1) infection in Kigali, capital city of Rwanda. METHODS: From September 1, 1989 until March 31, 1990 we conducted a study of all new patients admitted with acute arthritis to the outpatient and inpatient services of the Department of Internal Medicine at the Centre Hospitalier de Kigali, in Kigali, Rwanda, a city highly endemic for HIV infection. RESULTS: Thirty-six patients (27 men 9 women; mean age: 31 years, range 18-65) were included in the study. Twenty-six (72%) were HIV seropositive. Two main diagnostic categories emerged, both strongly associated with HIV infection: (1) aseptic arthritis: 16 (44.5%) patients including 12 (33.5%) patients with spondyloarthropathy of whom 10 (83%) were HIV seropositive, and 4 (11%) patients with HIV related arthritis, (2) septic arthritis: 11 (30%) patients of whom 9 (82%) were HIV seropositive, including 4 with gonococcal, 2 with staphylococcal, 1 with Salmonella B and 2 with tuberculous arthritis. CONCLUSION: In an area highly endemic for HIV, acute arthritis should be considered a possible manifestation of HIV infection and should prompt HIV testing.

Acquired Immunodeficiency Syndrome↗

[Lupus, sicca syndrome and chronic interstitial nephritis. Apropos of a case].

A female patient from the French Antilles developed renal failure due to pure chronic interstitial nephritis six months after the onset of systemic lupus erythematosus (SLE) for which she was taking hydroxychloroquine. Over time, results of biologic tests became suggestive of concomitant Gougerot-Sjögren syndrome, but neither the clinical nor the histologic findings were consistent with this diagnosis. The diagnosis of overlap syndrome between SLE and Gougerot-Sjögren syndrome was established only six years later when the patient developed ocular and oral sicca syndrome with enlargement of the parotid glands.

Adult↗