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Biomedical subjects

P Jeandel

Publications and source records attributed to P Jeandel.

At least 19 recordsLinked to original sources
PubMed2004

[Exotic viral arthritis: role of alphavirus].

Only six of the many alphavirus known to affect humans can cause articular manifestations. They are the Ross River and Barmah Forest viruses from the South Pacific, the Chikungunya, O'Nyong Nyong and Sindbis viruses from tropical Africa, and the Mayaro virus from South America. In most cases, articular manifestations involve arthralgia or transient arthritis and are usually minor. However in some cases especially involving Ross River virus acute polyarthritis may be the most prominent clinical feature and even develop before fever. Although these joint symptoms may be severe and persist for weeks or months in a subacute mode with slightly inflammatory episodes that can be relieved using analgesics, they never cause permanent damage. Differential diagnosis of alphavirsus-related polyarthritis is simple to diagnosis especially in epidemic outbreaks as is frequently the case for Ross River virus epidemics in Australia. Imported cases should be suspected in patients presenting acute or subacute polyarthritis after a recent stay of any length of time in a tropical country and can be confirmed by ordering serology from a specialized reference laboratory.

Alphavirus↗
PubMed2000

[Epithelioid hemangioendothelioma of the foot].

Epithelioid hemangioendothelioma is a rare bone tumor. The authors report a case of a grade 1 multifocal epithelioid hemangioendothelioma of the foot in a 24-year-old man treated by large surgical resection of the two lesions.

Adult↗
PubMed1997

Human African trypanosomiasis: MRI.

We report a case of human African trypanosomiasis caused by Trypanosoma brucei rhodesiense. After the febrile period of parasite dissemination, the patient had meningeal involvement but normal CT. MRI showed the appearances of meningitis. After two periods of arsenical treatment, a severe encephalopathy occurred suggesting post-therapeutic reactive encephalitis (PTRE). Nevertheless, T2-weighted MRI showed no oedema, but focal bilateral high signal areas in the white matter. PTRE was excluded and a third course of treatment was undertaken. The lesions progressively disappeared.

Adult↗
PubMed1997

[Bone lesions due to endemic African Kaposi sarcoma: a case report].

Based on clinical and epidemiological data Kaposi's sarcoma (KS) can be divided into four subtypes: classical KS, immunodepression-related KS (IKS), epidemic AIDS-associated KS (AKS), and endemic KS (EKS). EKS is the most common entity in intertropical Africa. The authors of this report describe a case of invasive KS of the extremities associated with metatarsal osteolysis in a 43-year-old man from Central Africa. The patient was seronegative for HIV. Osteolytic lesions associated with EKS are uncommon and present few specific symptoms. They are always associated with skin lesions and are sensitive to radiation therapy and/or systemic chemotherapy. With the growing HIV epidemic, the clinical features of EKS and AKS now overlap and distinction is no longer possible in Black Africa. However AKS rarely involves osteolytic lesions without unfavorable prognosis or unconventional therapeutic modalities. In patients who are seropositive for HIV, it is important to distinguish KS from bacillary angiomatosis. Since these two entities present similar clinical and radiological features, differentiation is usually achieved on the basis of histological findings but active therapeutic testing for bacillary angiomatosis may be necessary.

Adult↗
PubMed1996

[HIV infection manifesting as a pneumococcal spondylodiscitis].

In this report the authors describe a patient in whom pneumococcal spondylitis was the presenting manifestation of HIV infection and discuss bone and joint infections during HIV infection. The case report involves a 43-year-old man from Mali who was admitted for fever and back pain that occurred during upper airway infection. Pneumococcal spondylitis was diagnosed based on MRI images showing an epidural effusion and on positive hemocultures for Streptococcus pneumoniae. Initial standard x-ray findings were normal but repeat imaging revealed the disco-vertebral lesions. HIV serology was positive but there was no evidence of immunodepression or decreased CD4 lymphocyte levels. Since the introduction of antibiotics bone and joint involvement in pneumococcal disease has become uncommon in developed countries. In patients with HIV infection pyogenic arthritis is rare but the risk of pneumococcal disease is greatly enhanced and arthritic lesions can occur. Only eleven cases of pneumococcal arthritis associated with HIV infection have been reported in the literature. However the incidence of these infections seems higher in Black Africa where they account for 50% of pyogenic arthritis. The authors emphasize the lack of correlation between the stage of HIV infection and the onset of pneumococcal osteoarthritic infections which could account for occurrence of the latter as presenting manifestations of retroviral seropositivity.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Demonstration of subclinical pulmonary alveolitis in spondylarthropathies].

Restrictive ventilatory dysfunction, lowered diffusing capacity, and apical fibrosis have been reported in ankylosing spondylitis. To investigate the pathogenesis of these abnormalities, we studied distal airspace cytology by performing bronchoalveolar lavage in 34 spondyloarthropathy patients (ankylosing spondylitis, n = 16; reactive arthritis, n = 4; axial psoriatic arthritis, n = 2; and undifferentiated spondyloarthropathy with HLA B27-positivity in every case but one, n = 12). Mean age was 32.4 +/- 13.7 years. None of the study patients had apical fibrosis, lower respiratory tract infection, or exposure to airborne pollutants other than tobacco smoke. The control group was composed of nine subjects who had no lung or inflammatory diseases and were not using medications. Significantly higher proportions of lymphocytes were found in bronchoalveolar lavage specimens from patients, as compared with controls. This difference was not influenced by smoking or medication use (non steroidal antiinflammatory drugs, sulfasalazopyridine). Alveolar lymphocytosis was not correlated with laboratory tests for disease activity (erythrocyte sedimentation rate, serum IgA levels) or with the presence of restrictive ventilatory dysfunction. Increases in the proportion of lymphocytes were of similar magnitude in patients with ankylosing spondylitis and in those with other spondyloarthropathies. Absolute total cell counts and relative neutrophil counts were similar in patients and controls. However, among the patients with spondyloarthropathies, those with a disease duration of more than five years had a significantly higher proportion of neutrophils than those with a disease duration of less than five years. These findings demonstrate that spondyloarthropathy patients have subclinical lymphocyte alveolitis. Although of unclear significance, this alveolitis may be related to the development of apical fibrosis in some patients with ankylosing spondylitis.

Adult↗
PubMed1994

[Bone and joint sites of African histoplasmosis (Histoplasma duboisii). Apropos of a case and review of the literature].

The authors report a case of disseminated African histoplasmosis with bone and joint involvement in a black 28-year-old citizen of the Central African Republic who presented with a 17-month history of multiple osteoarticular lesions (sternoclavicular joints, humerus, ribs), cutaneous lesions (face, scalp, thorax), and lymphadenopathy. Clinical manifestations resolved rapidly under treatment with ketoconazole (600 mg/d for 10 days then 400 mg/day for nine months). Persistent yeast cells were then found upon examination of a lymph node biopsy specimen. The characteristics and diagnosis of osteoarticular lesions due to African histoplasmosis are discussed on the basis of a review of the literature. Bone and joint lesions due to African histoplasmosis have not yet been reported in patients with the acquired immunodeficiency syndrome. However, the expanding epidemic of human immunodeficiency virus infection in Africa can be expected to result in an increase in the incidence of African histoplasmosis. Imidazole derivatives are easier to use on a long-term basis than amphotericin B and have significantly improved our ability to treat African histoplasmosis.

AIDS-Related Opportunistic Infections↗
PubMed1994

[Epidemiology of bone fluorosis of hydrotelluric origin].

Although endemic fluorosis occurs in many countries, epidemiological studies have been limited by funding problems, a lack of awareness of the public health impact of the disease, and the absence of inexpensive defluoridation methods. The effects of fluorides on human bone are reviewed and the methodological problems raised by epidemiological studies of endemic skeletal fluorosis are discussed.

Bone Diseases↗