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Biomedical subjects

P Brouqui

Publications and source records attributed to P Brouqui.

At least 19 recordsLinked to original sources
PubMed2006

Prognostic factors associated with severe leptospirosis.

Leptospirosis is an anthropozoonosis caused by Leptospira interrogans. It occurs worldwide and is endemic in French Polynesia. Leptospirosis is associated with a large variety of clinical symptoms. Most infections caused by leptospires are either sub-clinical or of very mild severity, but 5-10% of infections result in multiple organ damage, including kidney, liver and lung lesions. Among 71 patients hospitalised in Papeete for severe leptospirosis during a period of 2 years, the main risk-factors for a severe outcome were hypotension, oliguria and an abnormal chest auscultation at the first physical examination. Survival depends on rapid diagnosis and early appropriate management. Well-defined criteria may help physicians to improve the timely treatment of high-risk patients.

Humans↗
PubMed2006

Serological evidence of Rickettsia infections in forestry rangers in north-eastern Italy.

The prevalence of antibodies to Rickettsiae and other tick-borne microrganisms in the sera of 181 forestry rangers from Friuli-Venezia-Giulia, Italy, was examined. Seven (3.9%) sera were positive for Rickettsia conorii and Rickettsia helvetica, as single or dual infections; four of these sera had been found previously to be positive for Borrelia burgdorferi. Antibodies to Coxiella burnetii were detected in five (2.8%) sera, four of which were also positive for B. burgdorferi. These findings indicate that patients in this north-eastern Italian region with fever subsequent to tick-bite should be investigated for Rickettsia and Coxiella infections.

Animals↗
PubMed2005

[Imported malaria at the Marseilles Hôpital-Nord, France: a prospective study on 352 cases between 2001 and 2003].

OBJECTIVE: The authors had for aim to study epidemiological, clinical, and parasitological characteristics, as well as regimen received, of imported malaria cases hospitalised at the North University Hospital, in Marseilles, France. DESIGN: The patients presenting with imported malaria included in this study were hospitalised in the infectious and tropical diseases unit and in the pediatrics unit at the North University Hospital, from January 1, 2001 to December 31, 2003. Variables were prospectively collected and recorded. RESULTS: 352 patients including 240 adults and 112 children were included. Most of them (67% of the adults and 92% of the children) were contaminated during a trip to the Comoros Islands. Plasmodium falciparum was the most common species identified. 97.5% of adult and 98% of child patients back from Comoros did not take any chemoprophylaxis against malaria or took inadequate regimens. Halofantrin was the most commonly used drug for children to treat uncomplicated P. falciparum malaria. In adults, atovaquone-proguanil was used as a first line drug in the absence of vomiting, and a 3-day intravenous regimen of quinine-clindamycin in case of vomiting. CONCLUSION: The specificity of imported malaria in Marseilles is the high proportion of Comorian patients who go back home periodically to visit friends and relatives. A better education of the Comorian population in Marseilles, regarding malaria risks and prophylaxis, needs to be implemented.

Adult↗
PubMed2005

Treatment of imported malaria in adults: a multicentre study in France.

BACKGROUND: Data about anti-malarial drugs prescription practices in Europe and the safety of imported malaria treatments are scanty. In 1999, a French consensus development conference published guidelines for the prevention and treatment of imported P. falciparum malaria. The impact of these guidelines has not been evaluated. AIM: To investigate the impact of these guidelines on the prescription of anti-malarials, and to evaluate the incidence of acute drug events (ADEs) leading to discontinuation of treatment. DESIGN: Cross-sectional survey. METHODS: Members of the medical staff in 14 French infectious and tropical disease wards completed a standardized form for each patient treated for imported malaria in 2001. A propensity score matching technique was used to estimate the risk of ADEs leading to discontinuation of the regimen. RESULTS: In the 474 patients studied, quinine was the first-line anti-malarial most often prescribed. Only 3% of patients received halofantrine. Mefloquine was associated with a RR of 4.9 (95%CI 3.2-7.4, p < 0.00001) risk of discontinuation of treatment due to ADEs. DISCUSSION: The very limited use of halofantrine indicates that the main practice recommendations of the guidelines have been taken into account. Mefloquine was associated with a substantial risk of discontinuing the treatment because of ADEs. This is a serious limitation for the use of mefloquine in the treatment of out-patients with imported malaria.

Adult↗
PubMed2005

Pseudo-tumor of the lung, a rare clinical presentation of dirofilariasis.

INTRODUCTION: Pulmonary dirofilariasis is an uncommon entity. Known as a zoonotic disease it can affect humans as a secondary host. A pseudo-tumor of the lung called "coin" lesion is usually detected while performing a chest X-ray for another reason. OBSERVATION: We present a case of pulmonary dirofilariasis due to Dirofilaria sp. in a 72 year old immunocompetent patient who underwent surgery for suspicion of a neoplasm. DISCUSSION: Human pulmonary dirofilariasis should be evoked in asymptomatic patient from endemic area of canine dirofilariasis presenting with a pseudo tumor of the lung.

Aged↗
PubMed2005

Cerebral infarction: an unusual complication of Mediterranean spotted fever.

Mediterranean spotted fever is a rickettsiosis caused by Rickettsia conorii and transmitted by the brown dog tick. It is considered as a benign disease but 5% to 10% of patients present with a malignant form which is the result of a diffuse vasculitis. We report here the first case of Mediterranean spotted fever with cerebral vasculitis and thrombosis leading to a massive cerebral infarct and death.

Journal Article↗
PubMed2005

Transmission of Rickettsia massiliae in the tick, Rhipicephalus turanicus.

Rickettsia massiliae, strain Bar29, was detected in engorged female ticks of the Rhiphicephalus sanguineus group collected in Corsica, a French Mediterranean island. Ticks were identified by molecular analysis as Rhipicephalus turanicus (Pomerantsev) (Acari: Ixodidae). Twenty larvae of the second generation obtained from a R. massiliae-infected, engorged female were tested by polymerase chain reaction (PCR) and all were positive for R. massiliae. Larvae of the same cohort were fed on rabbits and specimens of subsequent stages of the second and third generation of ticks were tested by PCR. Both transovarial and transstadial transmission were demonstrated; the transovarial transmission rate was estimated at 100%. A high filial infection rate was demonstrated; 132 out of 134 larvae obtained from five infected females of the fourth generation were infected. When saliva samples from half-engorged Rh. turanicus of the second generation were tested by PCR, four out of five were positive. Rickettsia massiliae was detected in faeces of infected ticks by PCR and immunofluorescence assay, although no rickettsiae could be maintained in culture. Co-feeding/transsexual transmission of R. massiliae Bar29 was demonstrated by feeding male Rh. turanicus on a rabbit with Rhipicephalus sanguineus (Latreille) (Acari: Ixodidae) females (the latter were the only uninfected ticks available). Infection was subsequently detected in nine out of the thirteen females (69.2%). These results suggest that Rh. turanicus ticks are potential vectors and reservoirs for R. massiliae Bar29.

Animals↗
PubMed2005

First case of osteomyelitis due to Shewanella algae.

Shewanella spp. are infrequently recovered from clinical specimens. We report here on the first case of osteomyelitis due to Shewanella algae. This bacterium, at first misidentified by phenotypic tests as Shewanella putrefaciens, was subsequently identified correctly as S. algae by 16S rRNA gene sequence analysis.

Bacterial Typing Techniques↗
PubMed2004

Concomitant or consecutive infection with Coxiella burnetii and tickborne diseases.

BACKGROUND: Q fever is a worldwide zoonosis caused by Coxiella burnetii, which can be isolated from ticks. Reports of people with both Q fever and other tickborne diseases are rare. In this study, we describe 6 patients with Q fever who were infected with 1 of the following tickborne pathogens: Rickettsia conorii (2 patients), Rickettsia slovaca (2), Rickettsia africae (1), and Francisella tularensis (1). METHODS: Diagnoses were made on the basis of results of microimmunofluorescence assays for detection of C. burnetii, R. conorii, R. slovaca, R. africae, and F. tularensis antigens. Cross-adsorption studies and Western blots were used to confirm dual infections. RESULTS: Among the 6 cases presented, 3 were probably due to a concomitant infection after a tick bite, whereas the remaining 3 were more likely consecutive infections. CONCLUSIONS: Because acute Q fever is often asymptomatic, we recommend that patients infected with the tickborne pathogens mentioned above also undergo routine testing for concurrent infections with C. burnetii.

Adult↗
PubMed2004

Schistosomiasis as an unusual cause of appendicitis.

Millions of people originating from tropical areas now live outside the country of their birth. As a consequence, the number of cases of diseases imported from the tropics and being seen by European physicians in immigrants is growing. As an example of such diseases, schistosomal appendicitis is a specific trait of infection with Schistosoma haematobium and is an uncommon cause of appendicitis in non-endemic areas. Treatment requires anti-schistomal medication in addition to surgery. Physicians, including surgeons, need to be aware of the possibility of seeing atypical presentations of parasitic diseases in immigrant patients.

Adult↗
PubMed2004

Guidelines for the diagnosis of tick-borne bacterial diseases in Europe.

Ticks are obligate haematophagous acarines that parasitise every class of vertebrate (including man) and have a worldwide distribution. An increasing awareness of tick-borne diseases among clinicians and scientific researchers has led to the recent description of a number of emerging tick-borne bacterial diseases. Since the identification of Borrelia burgdorferi as the agent of Lyme disease in 1982, 11 tick-borne human bacterial pathogens have been described in Europe. Aetiological diagnosis of tick-transmitted diseases is often difficult and relies on specialised laboratories using very specific tools. Interpretation of laboratory data is very important in order to establish the diagnosis. These guidelines aim to help clinicians and microbiologists in diagnosing infection transmitted by tick bites and to provide the scientific and medical community with a better understanding of these infectious diseases.

Animals↗
PubMed2003

Human anaplasmosis presenting as atypical pneumonitis in France.

Human anaplasmosis is a febrile illness caused by Anaplasma phagocytophilum, an intracellular bacterium transmitted by Ixodes ticks in the United States and Europe. Although cough is reported in 30% of the American cases, interstitial pneumonitis has been noted only once. Of the 9 confirmed cases reported in Europe, 3 presented with atypical pneumonitis. A. phagocytophilum should be added to the list of agents responsible for interstitial pneumonitis, especially in areas where human anaplasmosis is endemic.

Anaplasma phagocytophilum↗
PubMed2003

[Central nervous tuberculosis in patients non-VIH: seven case reports].

PURPOSE: Tuberculosis involving the central nervous system (CNS) is rarely observed in non immuno-compromised hosts. We report herin the various clinical, biological and radiological manifestations observed in 7 patients with CNS tuberculosis. METHODS: Clinical and biological records of 7 patients with CNS tuberculosis were retrospectively studied. All patients had encephalic CT-scan and MRI in the course of the disease. RESULTS: 5 women and 2 men with a mean age of 38.4 years initially initially presented with headache (n = 6), fever (n = 5), meningeal irritation (n = 3), localizing neurological signs (n = 1). Lumbar punction revealed lymphocytic meningitis (n = 6/7). Mycobacterium tuberculosis or bovis was isolated in 3 patients only. Cerebral tomodensitography or magnetic resonance imaging were initially normal in most of cases (n = 4/7), but discovered in the course of disease basilar meningitis (n = 6), hydrocephalus (n = 6), abcess or tuberculoma (n = 4). In all the patients, initiation of the treatment was complicated by clinical and/or biological deterioration, called paradoxal reaction, leading in all cases to glucocorticoid adjunction, with various final results. Indeed, 4 patients developed neurological sequelae. No patient died. CONCLUSION: CNS tuberculosis is a rare disease in non immunocompromised patients whose diagnostic may be difficult due to the absence of specific clinical symptoms, negative initial radiological examination, as well as delayed and often negative bacterial isolation. Paradoxal reaction appeared to be frequent despite specific antibiotherapy and underlines the beneficial effects of addictive corticosteroids.

Adrenal Cortex Hormones↗
PubMed2003

Chlamydia pneumoniae, but not Bartonella quintana, is associated with coronary heart disease: results of a French case-control study.

Serologic cross-reactivity has been demonstrated between Bartonella quintana and Chlamydia pneumoniae. Therefore, the association between antibodies to C. pneumoniae and coronary heart disease (CHD) as described in the literature may be due to antibodies cross-reacting with B. quintana. To investigate this hypothesis, we evaluated, in a case-control study, the prevalence of C. pneumoniae and B. quintana antibodies among 296 cases with angiographically significant artery lesions and 170 controls without angiographically demonstrable coronary artery disease. The prevalence of C. pneumoniae antibodies was higher among cases than among controls: 69% versus 49% (P < 0.001; OR 1.39; 95% CI (1.55; 3.52)). Multiple logistic regression demonstrated that C. pneumoniae seropositivity is an independent risk factor for CHD (adjusted OR 2.31; 95% CI (1.49; 3.60)). No statistically significant association was demonstrated between B. quintana seropositivity and CHD. Antibodies to both C. pneumoniae and B. quintana were found in nine subjects (seven cases and two controls), suggesting co-infection rather than cross-reactivity.

Bartonella quintana↗