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Y Hansmann

Publications and source records attributed to Y Hansmann.

13 recordsLinked to original sources
PubMed2001

[Procalcitonin in pyelonephritis and acute community-acquired pneumonia in adults].

OBJECTIVES: Procalcitonin (PCT) is an acute-phase protein involved in the specific inflammatory reaction to severe bacterial or fungal infections. This protein does however lack sensitivity in focal infections. PATIENTS AND METHODS: In this study, we investigated PCT, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), leukocytosis, and fibrinogen levels at admission among adult patients hospitalized for community-acquired pneumonia (n = 33) or pyelonephritis (n = 30) and in a control population (n = 27) of patients with viral infections and non-infectious inflammatory diseases. RESULTS: Median serum PCT in the control group (0.21 ng/ml) was significantly lower than in the pyelonephritis group (0.46 ng/ml, p < 0.0005) or the pneumonia group (0.88 ng/ml, p < 0.0005). In the control group, median CRP was 51.4 ng/l reaching 220 mg/l in the pyelonephritis and 198 mg/l in the pneumonia group (p < 0.0005 in both cases). The other markers of inflammation investigated (leukocytosis, ESR, fibrinogen) did not show such differences between the control group and the sepsis groups. The sensitivity of PCT (threshold 0.5 ng/ml) was 61% for the diagnosis of pneumonia and 44% for the diagnosis of pyelonephritis. Specificity was 92% in both cases. In comparison, the sensitivity of CRP (threshold 50 mg/l) was 94% and 91% for pyelonephritis and pneumonia respectively with a 33% specificity in both cases. CONCLUSION: PCT is a specific but poorly sensitive marker of community-acquired pneumonia and pyelonephritis among adults hospitalized in medical wards.

Adult↗
PubMed2001

Invasion and persistent intracellular colonization of erythrocytes. A unique parasitic strategy of the emerging pathogen Bartonella.

The expanding genus Bartonella includes zoonotic and human-specific pathogens that can cause a wide range of clinical manifestations. A productive infection allowing bacterial transmission by blood-sucking arthropods is marked by an intraerythrocytic bacteremia that occurs exclusively in specific human or animal reservoir hosts. Incidental human infection by animal-adapted bartonellae can cause disease without evidence for erythrocyte parasitism. A better understanding of the intraerythrocytic lifestyle of bartonellae may permit the design of strategies to control the reservoir and transmittable stages of these emerging pathogens. We have dissected the process of Bartonella erythrocyte parasitism in experimentally infected animals using a novel approach for tracking blood infections based on flow cytometric quantification of green fluorescent protein-expressing bacteria during their interaction with in vivo-biotinylated erythrocytes. Bacteremia onset occurs several days after inoculation by a synchronous wave of bacterial invasion into mature erythrocytes. Intracellular bacteria replicate until reaching a stagnant number, which is sustained for the remaining life span of the infected erythrocyte. The initial wave of erythrocyte infection is followed by reinfection waves occurring at intervals of several days. Our findings unravel a unique bacterial persistence strategy adapted to a nonhemolytic intracellular colonization of erythrocytes that preserves the pathogen for efficient transmission by blood-sucking arthropods.

Animals↗
PubMed2001

Disease expression of Lyme borreliosis in northeastern France.

Since very little is known about the clinical expression of Lyme borreliosis in Western Europe, a 3-year prospective study was conducted that included all patients seen for suspected Lyme borreliosis at the Strasbourg University Hospital in northeastern France. The diagnosis of Lyme borreliosis was made on the basis of the presence of erythema migrans or on the basis of another suggestive clinical manifestation and laboratory confirmation. A total of 132 patients, 70 women and 62 men, mean age 54 years, had Lyme borreliosis according to these criteria. Within this study group, 77% of the patients were regularly exposed to tick bites and 64% could remember one. Erythema migrans, the most frequent clinical manifestation, occurred in 60% of the patients and was the only sign of Lyme borreliosis in 40%. Lymphocytoma and acrodermatitis chronica atrophicans were rare (1 and 3 patients, respectively). Nervous system involvement (mainly radiculoneuropathy), the second most common clinical manifestation, was found in 40% of the patients and was the only sign of Lyme borreliosis in 22%. Musculoskeletal involvement was present in 26% of the patients and was an isolated finding in 14%. During the study period, no patient was diagnosed with Lyme carditis. There was serological evidence of Lyme borreliosis in 75% of the cases and direct evidence of borrelial infection in 10 (7.5%). The results show that the clinical expression of Lyme borreliosis in northeastern France is similar to that in other European countries but different from that in North America.

Adolescent↗
PubMed2001

[What data is needed today to deal with erysipelas?].

Erysipelas are common dermo-hypodermal infections. In spite of that, different questions are not clearly resolved. To improve our knowledge of this infection, it is important to have epidemiological, microbiological and diagnostical data. The current data are summarized in this article after a bibliographic research. The epidemiology has changed, with an increase of the number of erysipelas of the leg whereas face localization is less frequent. Some facilitating factors can be individualized, like circulatory insufficiency of the legs. There are only few data concerning pathophysiology. The diagnosis is mainly made on clinical symptoms. There is no specific diagnostic test. The bacteria that cause erysipelas is rarely isolated in clinical practice. The group A Streptococcus is the most frequent bacteria in erysipelas. It is important for physicians, to have a better knowledge of this infection, so that the efficacy of the treatment can be improved.

Erysipelas↗
PubMed2000

Direct molecular typing of Borrelia burgdorferi sensu lato species in synovial samples from patients with lyme arthritis.

Since Lyme arthritis was first described in the United States, it has now been reported in many countries of Europe. However, very few strains of the causative bacterium, Borrelia burgdorferi, have been isolated from synovial samples. For this reason, different molecular direct typing methods were developed recently to assess which species could be involved in Lyme arthritis in Europe. We developed a simple oligonucleotide typing method with PCR fragments from the flagellin gene of B. burgdorferi sensu lato, which is able to differentiate seven different Borrelia species. Among 10 consecutive PCR-positive patients with Lyme arthritis from the northeastern France, two species were identified in synovial samples: B. burgdorferi sensu stricto in 9 cases and B. garinii in 1 case. Conversely, all B. burgdorferi sensu lato species detected in 10 consecutive PCR-positive biopsies from a second set of patients with erythema migrans from the same geographical area were identified as either B. afzelii or B. garinii (P < 0.001). These results indicate that B. burgdorferi sensu stricto is the principal but not the only Borrelia species involved in Lyme arthritis in northeastern France.

Arthritis, Infectious↗
PubMed1999

Isolated renal Aspergillus abscess in an AIDS patient with a normal CD4+ cell count on highly active antiretroviral therapy.

Isolated renal Aspergillus abscess is a very rare complication of HIV infection. It usually occurs in patients with severe immune deficiency. The case of a 29-year-old HIV-infected homosexual male, a nonintravenous drug abuser, who developed a right renal Aspergillus abscess despite normalization of the CD4+ cell count after highly active antiretroviral treatment is described. When antimicrobial treatment failed (amphotericin B followed by itraconazole), he was cured by right nephrectomy and remains in good health 3 months later with no recurrence. In cases of Aspergillus renal abscess in HIV-infected patients, surgery is the treatment of choice, especially in the current era of highly active antiretroviral therapy.

AIDS-Related Opportunistic Infections↗
PubMed1999

[A case report of post-rubella myelitis in an adult].

Neurological complications following rubella are only rarely encountered. We report a case of isolated myelitis. A 44-year-old healthy female suffered from an erythematous macular rash which rapidly cleared. However, the following days, dysuria initiated hospitalization. On admission, she was febrile but alert and in normal mental status. General physical examination was quite unremarkable. Four days later, she suffered from acute urinary retention, fecal retention and vaginal hypoesthesia. Routine laboratory data, chest skull and spinal column X-rays were unremarkable. The sterile cerebrospinal fluid contained 30 lymphocytes/mm3, 0.48 g/ml of protein but normal amount of glucose. Rubella antibody titers showed a significant elevation and specific IgM were detected by immunocapture. Improvement was rapid and recovery was uneventful except a mild vaginal hypoesthesia that persisted 5 weeks later. Diffuse myelitis occurring shortly after rubella vaccination have also been described. The immunopathological mechanisms by which involvement of the nervous system occurs is far from clear. Little is known about the pathogenesis of post-vaccination myelitis and although the mecanism of sensitization and the specific neural antigens are not known, post-infectious and post-vaccinal myelitis are thought to share a common pathogenic basis.

Adult↗
PubMed1998

[Group A Streptococcus pyomyositis].

BACKGROUND: Pyomyositis is a group of infectious diseases involving muscle tissue. Staphylococcus aureus is usually the causal agent. Group A Streptococcus infections are uncommonly isolated in pyomyositis. Streptococcal pyomyositis can be distinguished by its severity. Death rate may be as high as 50%. CASE REPORTS: Diagnosis of cervical pyomyositis was made in 2 patients on the basis of ultrasound and computerized tomography findings. Group A Streptococcus was isolated from local samples. The diagnosis was confirmed at surgery. Host defense mechanisms were not deficient in either patient. Outcome was favorable in both patients after antibiotic therapy. DISCUSSION: Because of the seventy of group A streptococcal pyomyositis, early diagnosis is essential for prognosis. Ultrasound and computerized tomography are very helpful. Group A streptococcal pyomyositis should be considered as a life-threatening disease.

Adult↗
PubMed1998

Bartonella tribocorum sp. nov., a new Bartonella species isolated from the blood of wild rats.

Two Bartonella strains from blood of two wild rats (Rattus norvegicus) living in a rural environment were isolated. These strains were distinct from all previously known Bartonella species based on phenotypic and genotypic characteristics. This new species is distinguished by its trypsin-like activity, the absence of the ability to hydrolyse proline and tributyrin, its 16S rRNA and citrate synthase gene sequences and by whole-DNA hybridization data. This new species, for which the name Bartonella tribocorum sp. nov. is proposed, seems to be genetically related to Bartonella elizabethae, an agent isolated in a case of human endocarditis. The type strain of Bartonella tribocorum sp. nov. is IBS 506T (CIP 105476T).

Animals↗
PubMed1998

[Emphysematous pyelonephritis].

Pyelonephritis is a frequent infection of variable severity. Mortality is low since the era of antibiotics. Emphysematous pyelonephritis is however a rare but life threatening form of kidney infection, which affect more frequently diabetic subjects, characterized by gas producing bacteria. These gaseous lesions can be localized in the renal parenchyma or in the perirenal or retroperitoneal space. Diagnosis became easier with the advent of CT scan. Treatment usually requires surgery and antibiotics. We report a case of emphysematous pyelonephritis in a diabetic patient. The CT scan strongly suggested the diagnosis which was confirmed per-operatively. Proteus mirabilis is exceptionally described in emphysematous pyelonephritis.

Aged↗
PubMed1997

[Malaria brought into Strasbourg: an epidemiological, clinical, biological and therapeutic study].

In a retrospective study, we registered 210 patients hospitalized in Strasbourg for malaria from 1984 to 1995. The diagnosis was always confirmed by presence of the parasite on blood smears. We analysed the epidemiological, clinical, biological and therapeutic data. The number of cases rose each year, with a maximum in 1995. The majority of cases occurred in January and from August to October, these periods corresponding with the return of travelers. In most cases, infection took place in Africa. In this region, Plasmodium falciparum is the most frequent species of the parasite. The mean age of the patients was 33 years. The clinical manifestations were polymorphic: fever, chills, sweating, and headache were very frequent. We noted 15 serious infections (with the WHO's definition) and two cases of cerebral malaria. All cases had a favorable outcome. Five cases occurred in pregnant women; two of them had a severe form of malaria. Among the biological abnormalities, we found thrombopenia, haemolysis, hypocholesterolaemia and hypertriglyceridaemia. The significance of disturbance of the lipid metabolism is not known. Hypocholesterolaemia is very frequent, and hypertriglyceridaemia seems to be associated with severe malaria. Most malaria attacks occurred in patients without adequate chemoprophylaxis. This confirms the importance of prophylactic information given to patients by their physicians. Resistance develops against each new medication that is available; among these quinine remains the drug of choice to cure severe malaria.

Adult↗