[Epididymal dirofilariasis mimicking testicular torsion in an adolescent].
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Biomedical subjects
Publications and source records attributed to P Marty.
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The authors report the results of investigations in Nice from July, 16 to August, 3, 1991. The 2,098 phlebotomes captured represent three species: Phlebotomus perniciosus, Phlebotomus ariasi and Sergentomyia minuta. Two species: P. perniciosus and P. ariasi are infected with promastigotes. About 4% of dissected females are parasited. This is the first description in France of P. perniciosus infected.
Twenty-six cases of congenital toxoplasmosis observed in the department of Alpes Maritimes (Chief Town: Nice) between 1984 and 1990 are reported. All affected children were treated by pyrimethamine and sulfonamide as soon as the diagnosis was established. None of them exhibited serious sequellae. In most cases (58%) there were no clinical manifestations in agreement with other reports. Benign manifestations were observed in 10 cases (38%): 4 chorioretinitis; 4 intracranial calcifications: 1 febrile seizure; 7 hyperproteinorachias: 3 isolated and 4 associated with other signs. In 3 cases, secondary lesions appeared during the treatment period. This confirms the need for active therapeutic research in order to decrease the risk of late ocular complication which is the major problem of the disease.
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A case of fatal visceral leishmaniasis due to a dermotropic strain of Leishmania infantum (Zymodeme MON-24) is related in an AIDS patient in spite of a specific treatment.
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The relationship between psychosomatic characteristics and the risk of breast cancer was studied in women aged from 35 to 65 years, presenting with a clinically palpable breast tumor. To permit a double-blind design, the psychosomatic evaluation obtained by a long open-ended interview was completed before any diagnostic procedure. On the basis of this evaluation, the psychosomatician concluded that the patient was at high or low risk of serious disease. Several other psychological parameters were also recorded, and the diagnosis was then established by cytology or histology. Nineteen of the 77 patients finally included in the study had histologically verified breast cancer. The relative risk (RR) of breast cancer associated with psychosomatic factors was estimated by multivariate unconditional logistic regression, taking into account age at interview, family history of breast cancer, parity and age at first delivery. A significant relationship (p = 0.02) was found between psychosomatic prognosis and the relative risk of breast cancer. Both the low and high risk groups identified by the psychosomaticians had a similar mean age (46.1 versus 47.6 years). Fundamental mental structure played a predominant role in the risk of breast cancer, since no case was observed among the 18 patients with well organized neurosis, and all the 19 malignant tumors were observed among patients with poorly organized neurosis or psychosis (RR = 7.8, p = 0.009). In addition, excessive self-esteem (RR = 10.0, p = 0.02), hysterical disposition (RR = 7.5, p = 0.02), and unresolved recent grief (RR = 8.2, p = 0.05), were found to be significantly related to the risk of breast cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
Sixteen bronchoalveolar lavages (BAL) were performed in 15 children with HIV1 seropositivity, 12 of them being infected by HIV1. BAL was performed during episodes of acute pneumonitis with respiratory distress (group I: three cases) or without severity (group II: five cases), or in the presence of asymptomatic radiological pulmonary abnormalities (group III: seven cases). A specific diagnosis of infection was obtained in five cases of acute pneumonitis and 12 micro-organisms were identified by BAL: three cytomegaloviruses, three respiratory syncytial viruses, two Pneumocytis carinii, one Haemophilus influenzae, one Herpes simplex virus type 1, one Escherichia coli and one group A streptococcus. In three cases two micro-organisms were simultaneously identified. Cytological examination showed a high proportion of polymorphonuclear leukocytes in cases of acute pneumonitis (group II) and alveolar lymphocytosis in clinically asymptomatic children with radiological pulmonary abnormalities (group III). BAL appears to be a reliable tool for the investigation of pulmonary infections in children with HIV1 seropositivity. In addition it has the advantage of revealing latent cytological abnormalities in these patients.
We observed one case of neurocysticercosis due to Taenia Solium. The patient had stayed at the Green Cap Islands and in Portugal until 1987, when he arrived in France and died one month later. The diagnosis had been suspected from the results of computerized tomography and serological examination. Finally, we confirmed that diagnosis by the post mortem parasitology study of the specimen of brain.
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A 65-year-old man who had lived in several tropical countries, particularly in Brazil, is observed for an ulcerative lesion of the mouth that appeared two months ago. The biopsy reveals polymorphic granuloma with numerous giant cells. PAS and Gomori-Grocott stains show very numerous roundish structures of variable size (3 microns to 15 microns). There are multiple buds like in paracoccidioidomycosis but culture reveals Histoplasma capsulatum. These abnormal forms have been described in large necrotic zones and especially in endocarditis (intravascular proliferations). To our knowledge, it is the first description of these forms in primary infestation. This case shows the necessity to control histological diagnosis of mycosis. Culture and biological identification are absolutely necessary for specific diagnosis.
The authors present two cases of neurocysticercosis diagnosed both by serology and medical imaging (computed tomographic scan and magnetic resonance imaging). The first patient had a mixed form with localization of the parasites in the different anatomic parts. He developed suddenly a severe encephalitis which growth has been quickly fatal in spite of a prompt praziquantel and corticosteroids treatment. The second patient had a parenchymal form, and the same treatment was very effective.
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