Biomedical subjects
Publications and source records attributed to Y Peloux.
The authors have observed a case of Fusobacterium necrophorum associate with Actinomyces odontolyticus septicemia, which appears to be the first case reported. In a 19 year old man, 15 blood cultures allowed to isolate both germs. Clinical manifestations were: acute-like abdomen, encephalitis, myocarditis and pleural effusion. Treatment with amoxicillin and metronidazole was successful.
The authors report a case of septicemia due to Leptotrichia buccalis in a patient with underlying lymphatic leukemia. It is the second case reported in the literature. This observation shows, once again, that bacteria known as "non virulent" can exhibit pathogenicity in immunosuppressed patients.
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Bacterial infections of the peritoneum may be primary (pneumococcal peritonitis of childhood). These are rare, as are Streptococcal and Staphylococcal peritonitis in the neonate, following umbilical or tegumental infections. The great majority of cases of peritonitis are secondary to an adjacent inflammation, a perforation of the gastro-intestinal tract, or trauma, which may be surgical in origin. The microbial flora involved is generally mixed, with a high proportion of anaerobic organisms, reflecting the composition of the intestinal flora, and in particular, that of the colon. Infections due to a single organisms are less common, and are seen principally in superinfected ascites, high perforations, or following preoperative antibiotic therapy. The treatment of peritonitis is thus dependent upon the microbial flora present. In mixed infections, broad spectrum antibiotic therapy (amino-glycosides + beta lactamines) is necessary, combined with a b-nitro-ionidazole derivative in view of the frequent presence of Bacteroides fragilis. When the infection is due to one or a limited number of organisms, only the antibiotic sensitivy will provide useful indications. The dangers of preoperative "sterilization", which leads only to the selection of multiresistant strains, is emphasized. Such sterilization is thus to be proscribed in the prevention of peritonitis. Antibiotic cover, on the other hand, is still indicated.
Nocardioses are unusual broncho-pneumopathies with a dangerous evolution which should be better known. They occur usually, except in case no. 1, in patients with decreased immunity. For this reason they belong to superinfection with opportunist germs. It should be kept in mind when identfying the nocardia so as to start an early specific treatment.
On the basis of eight cases of Bacteroides fragilis septicaemia, the authors review recent data from the literature related to this topic. They first note the increasing prevalence, accounting for approximately 10 per cent of all septicaemias at the present time. They note that the most frequent portals of entry are sites of localised suppuration, related on the one hand to digestive or gynaecological surgery and, secondly, to the post-partum or post-abortum period. From a therapeutic standpoint, they stress the important role of imidazole derivatives (metronidazole or tinidazole) which are the most effective antibiotics at present. Certain authors even suggest their use on a preventive basis in high risk subjects.
A case of subcutaneous abscess of the chest-wall due to Eikenella corrodens is reported in a patient recently splenectomized. This bacillus was grown in pure culture. Processing specimens and identification methods of this little Gram-negative bacillus are described. Eikenella corrodens is a commensal frequently encountered in mucous membrane surfaces. It is likely that this microorganism may be an "opportunist" pathogen.
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The authors report a case of bacteriemia with Bacillus licheniformis in a pregnant woman with coagulation disorders (acute fibrinolysis). Eight blood cultures were positive. Recovery rapidly occurred. The origin of this affection is discussed : a venous mode of entry is possible, either by the use of contaminated infusion fluid, or following several catheterizations.
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