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Y Le Fichoux

Publications and source records attributed to Y Le Fichoux.

At least 55 records · Page 3Linked to original sources
PubMed1996

[Subcutaneous cysticercosis].

INTRODUCTION: The case of a patient originated from Angola who presented subcutaneous and neurologic cysticercosis is reported. OBSERVATION: The patient was referred for the etiological diagnosis of recurrent seizures. The diagnosis was made by histologic examination of a subcutaneous lesion. COMMENTS: We review the clinical characteristics of subcutaneous cysticercosis. The association of subcutaneous nodules and signs of central nervous involvement occurring in a patient originating from an area where cysticercosis is endemic, must be suspected of cysticercosis.

Adult↗
PubMed1995

[Persistent diarrhea in HIV infected patients: role of Enterocytozoon bieneusi].

OBJECTIVES: To determine the epidemiologic, clinical and aetiologic features of chronic diarrhoea in patients with human immunodeficiency virus (HIV) infection. METHODS: Between January 1992 and April 1993, all HIV positive patients with chronic diarrhoea were enrolled in a prospective study. There were 46 patients in the study group including 33 (22 homosexuals) in stage C according to the 1993 Centers for Disease Control classification. RESULTS: Thirty-four pathogenic agents were isolated in 26 of the patients (57%). Enterocytozoon bieneusi was the most frequently found pathogen (11 patients, 24%) followed by Cryptosporidium sp (8 patients). Enterocytozoon bieneusi was found in association with other pathogens in 7 patients. All patients with microsporidiosis were in stage C (p = 0.04) and had a longer duration of diarrhoea (19.6 vs 9.8 weeks, p = 0.03), greater weight loss (9.6 vs 2.1 kg, p = 0.0003) and a lower Karnofsky index (48% vs 67%, p = 0.01). Prophylaxy with dapsone or pyrimethamine during the 3 months prior to inclusion had been more frequent (p = 0.04 and p = 0.05 respectively) in patients without microsporidiosis. CONCLUSION: Microsporidiosis should be suspected as a probable cause of chronic diarrhoea in HIV positive patients with a CD4 count < 100/mm3. Multiple infections may be a factor leading to treatment failure. Microsporidiosis seems to be linked to homosexual intercourse.

AIDS-Related Opportunistic Infections↗
PubMed1995

Atypical leishmaniasis in a patient infected with human immunodeficiency virus.

Visceral leishmaniasis is an anthropozoonosis endemic in the south of France. Its occurrence among patients infected with human immunodeficiency virus (HIV), in whom it presents with uncommon clinical, biological, and evolutionary signs, is being reported more and more often. We describe a case of leishmaniasis in an HIV-seropositive man that we believe is unique with respect to the cutaneous and then visceral location of the disease and the discovery at necropsy of an adrenal and myocardial leishmanial infiltrate.

AIDS-Related Opportunistic Infections↗
PubMed1995

Human T-cell activation by 14- and 18-kilodalton nuclear proteins of Leishmania infantum.

Leishmanial antigens which stimulate T lymphocytes from primed individuals may be candidates for a vaccine. We recently found a significant concordance between the humoral response specific for two proteins from Leishmania infantum promastigotes, p14 and p18, and a positive leishmanin delayed-type hypersensitivity reaction, testifying to the occurrence of cell-mediated immunity. In this communication, we describe a partial characterization of these antigens and an in vitro analysis of their capacity to activate primed human T cells. We showed, by immunofluorescent staining and through analysis of subcellular fractions by Western immunoblotting, that in stationary-phase promastigotes, p14 and p18 were located only in the parasite nuclei; in the middle of the log phase, a transitory and only weak expression outside the nucleus was detected. We then showed that p14 and p18 antigens shared a common epitope(s). Finally, we analyzed the in vitro proliferation and interleukin-2 production induced by leishmanial proteins in human peripheral blood mononuclear cells from sensitized subjects. We showed that in some individuals who have been exposed to L. infantum the specific response to the whole lysate was mostly due to the nuclear antigens. We demonstrated directly the capacity of nitrocellulose-bound p14 and p18 to activate in vitro all of the tested primed peripheral blood mononuclear cells, which contrasted with a lack of stimulatory activity of other membrane-bound leishmanial proteins. Taken together, our results suggest that an antigenic determinant(s) dominant for some individuals might exist on both antigens.

Animals↗
PubMed1994

[Childhood visceral leishmaniasis in the Alpes-Maritimes from 1985 to 1992].

Here, we present an analysis of clinical and biological data from 15 infantile visceral leishmaniasis recorded between 1985 and 1992 in the French department of Alpes-Maritimes. The association of fever, splenomegalia, tricytopenia remains the most constant and predictive of diagnosis (90% of cases). Bone marrow smear affirms diagnosis in 93% of cases. Leishmania infantum MON-1 is the causative agent. Except for one case of advanced stade with severe hepatic lesions and one case of clinical resistance to Glucantime, prognosis is favourable under treatment with antimony derivatives. The long term results for children considered cured after initial treatment is satisfactory. In the department, the number of cases of combined ages has increased regularly since 1985. The number of infantile forms has increased but now represents nevertheless no more than 28% of total cases. On the other hand, cases are increasing in adults and 40% of those adult cases are in HIV positive patients.

Adolescent↗
PubMed1993

Extracerebral toxoplasmosis in the acquired immunodeficiency syndrome (AIDS).

Although Toxoplasma gondii frequently causes lesions of the central nervous system in AIDS, the exact incidence of extracerebral toxoplasmosis in these immunodepressed patients remains difficult to determine. Isolation of the parasite outside the central nervous system is rarely performed ante mortem, and most diagnoses of extracerebral toxoplasmosis are made post mortem. This article describes 23 cases of extracerebral toxoplasmosis diagnosed between 1987 and 1991 in an autopsy series of 170 patients infected with the human immunodeficiency virus (HIV). Ante mortem diagnosis of extracerebral involvement was affirmed in 4 of these 23 patients by identification of trophozoites in bronchoalveolar lavage fluid (2 cases), a surgical pulmonary biopsy specimen, and a bladder biopsy. Clinical and paraclinical findings suggested cardiac involvement in 4 other patients. Post mortem examination demonstrated disseminated toxoplasmosis in 18 cases and extracerebral monovisceral involvement in 5 cases. Extracerebral toxoplasmosis was directly responsible for the death of 6 patients. The most frequent extracerebral sites of Toxoplasma gondii involvement were the heart (21/23 cases; 91%), the lungs (14/23 cases; 61%) and the pancreas (6/23 cases; 26%). The tissular consequences of toxoplasmic involvement varied considerably, from formation of pseudocysts or cysts without any surrounding inflammatory reaction to necrotic lesions rich in neutrophilic polynuclear cells containing numerous free parasites. Immunoperoxidase study using antitoxoplasmic antibodies contributed to the diagnosis of 8 extracerebral localizations. Electron microscopy examination of a surgical lung biopsy and myocardial specimens (2 cases) demonstrated the ultrastructural characteristics of Toxoplasma gondii trophozoites.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Toxoplasmosis in AIDS patients. Pathoclinical study of 78 cases].

We report 78 cases of toxoplasmosis diagnosed between 1987 and 1992, from an autopsy study of 205 patients infected by the human immunodeficiency virus (HIV). Of the 78 patients 22 were females (28%) and 56 males (72%). Risk factors were as follows: intravenous drug addiction (44 cases, 56%), homosexuality or bisexuality (18 cases; 36%) and multiple blood transfusions (6 cases). Cerebral toxoplasmosis (CT) was diagnosed in 73 cases (93%) and was characterized by abscesses (59 cases), diffuse encephalitic lesions (8 cases), isolated cysts without inflammation (3 cases) and hemispheric involvement with ventricular hemorrhage (3 cases). Cerebral involvement were isolated (55/78 cases; 70%) or associated with multi-visceral diffusion (18/78 cases; 23%). Isolated extracerebral localization was observed in 5 cases. The most frequent extracerebral sites were: cardiac (21 cases), pulmonary (14 cases) and pancreatic (7 cases). Immunohistochemical study with anti Toxoplasma gondii antibodies allowed to a diagnosis of extracerebral localization in 8 cases. Ultrastructural features of Toxoplasma gondii were studied on post mortem myocardial samples (2 cases) open lung biopsy (1 case) and bladder biopsy specimen (1 case). Antemortem diagnosis of cerebral toxoplasmosis was performed on CT-scan in 59/73 (80%). Antemortem diagnosis of extracerebral toxoplasmosis was performed or suspected in 8/23 cases (34%): by isolation of trophozoites in bronchoalveolar lavage (2 cases), on an open lung biopsy (1 case) and on a bladder biopsy specimen (1 case), and by clinical and echocardiographic data (4 cases). Anti-toxoplasmic serology allowed to the diagnosis of toxoplasmosis in 12/78 cases (15%) by showing high levels of IgG in the serum.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Opportunistic Infections↗
PubMed1993

[Visceral leishmaniasis resistant to conventional treatments: value of amphotericin B].

The reference treatment in visceral leishmaniasis is administration of antimonial compounds (Pentostam, Glucantime). Primary and secondary failures have been reported and may involve several mechanisms resulting in alterations in the T-cell-dependent response, particularly in HIV-positive patients. Alternative agents proposed for use as single-drug therapy or in combination with other drugs include Lomidine, which carries a high risk of toxicity, allopurinol, cytokines (IL-2 and interferon gamma), and amphotericin B. Amphotericin B, in addition to effects on the metabolism of sterols in the wall of the protozoan, induces macrophage activation. This article illustrates the difficulty of treatment of visceral leishmaniasis by reporting the case of an immunocompetent 36-year-old patient whose bone marrow cultures remained positive after successive treatment, over 48 months, with two courses of Glucantime (60 mg/kg/day for 15 days), one course of allopurinol (10 mg/kg/4 weeks), two courses of Glucantime in combination with interferon gamma, splenectomy, and one course of Pentostam (20 mg/kg/4 weeks). Bone marrow cultures became negative after administration of amphotericin B (1 mg/kg every 48 hours for 8 weeks). Cytokine studies disclosed defective production of IL-2, IL-1 beta, and IFN gamma. Amphotericin B seems to be a valuable alternative when conventional treatment fails. The liposomal form is especially promising.

Adult↗
PubMed1992

Comparative study of ketoconazole 2% foaming gel and betamethasone dipropionate 0.05% lotion in the treatment of seborrhoeic dermatitis in adults.

Sixty-two patients with seborrhoeic dermatitis were treated topically with a 2% ketoconazole foaming gel or with a 0.05% betamethasone dipropionate lotion in a single-blind study for 4 months. Changes in the number of Pityrosporum ovale were scored by a mycologist. The investigator rated the severity of erythema, scaling and itching of the patients' scalp, eyelashes, nasolabial folds and thorax. In addition, both the investigator and the patients evaluated the treatments globally. At the end of treatment, the response rate for ketoconazole 2% foaming gel was significantly higher than that for betamethasone dipropionate 0.05% lotion according to the global evaluation by the physician (89 vs. 62%, p less than 0.05) and the patient (89 vs. 65%, p less than 0.05). Ketoconazole was also superior to betamethasone with reference to the evolution of the symptoms, irrespective of their localization. This efficacy manifested itself by a significant reduction of the number of P. ovale on the scalp in the ketoconazole group (p less than 0.001) compared to the betamethasone group, in which the count was hardly changed during therapy. The treatment was also better tolerated in the ketoconazole group (5 vs. 16 patients with side-effects, p less than 0.001). It is concluded that ketoconazole 2% foaming gel offers an excellent alternative to local corticosteroids in the treatment of seborrhoeic dermatitis.

Administration, Topical↗
PubMed1992

The skin as the possible reservoir for Candida albicans in the oculocutaneous candidiasis of heroin addicts.

We describe 2 patients who injected themselves with the same brown heroin a few days before hospitalization. The first patient presented with characteristic oculo-cutaneous candidiasis. Blood samples remained sterile during the so-called 'septicemic syndrome' which represents the first phase of this syndrome and were positive for Candida albicans only when cutaneous nodules developed. The second patient was hospitalized for a stomach perforation and had no cutaneous or ocular candida involvement. Both patients were unusually colonized by C. albicans on their skin (particularly on hairy zones). These observations support the hypothesis that the skin may constitute the reservoir for C. albicans in oculo-cutaneous candidiasis.

Adult↗
PubMed1992

[Phlebotomus perniciosus Newstead, 1911 naturally infected by promastigotes in the region of Nice (France)].

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.

Animals↗