[Tamponade in the course of legionellosis: case report and review of the literature].
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Biomedical subjects
Publications and source records attributed to A Sotto.
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Imported dengue is increasingly observed in non endemic countries. We report a retrospective study of 44 cases of dengue fever diagnosed in nine french university hospitals between 1994 and 1997. The patients were aged between 13 and 67 years. Most of them were tourists and had been traveling for a few weeks, in French West Indies and French Guyana (18), South-East Asia (10), India (7) or Polynesia (4). Only, two contracted the disease in Africa. The onset of symptoms preceded the return or followed it within 7 days. The most frequent clinical presentation was a febrile and painful syndrome. Cutaneous manifestations (rash or macular exanthem) were observed in 59% of cases, digestive symptoms in 50%, pharyngitis and/or cough in 25%, microadenopathy in 20%, moderate mucous haemorrhagic manifestations in 16% and neuropsychiatric manifestations in 14%. The common biological abnormalities were thrombocytopenia (84%), leukopenia (59%), and elevated transminases (57%). The diagnosis, orientated by negativity of malaria smears, the knowledge of an epidemic in the visited country, or occurrence of similar cases in the entourage, were argued by serological results: presence of anti-DEN IgM in 25 cases, serological conversion (anti- DEN IgG) in 7 cases or very high seropositivity (anti-DEN IgG > 1/1280) in 12 cases. No virus isolation was obtained.
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Pulmonary involvement is very rare in giant cell arteritis. The sign that is most often encountered seems to be dry cough which can remain, for a long time, the sole manifestation of this disease. We report a case of giant cell arteritis in a 66 year old woman that expressed for only symptom a dry cough during one year. A rapid regression of clinical symptoms and radiologic signs have been observed with steroid therapy. Presence of isolated cough along with biological marks of inflammation in a elderly patient should lead to temporal biopsy when no other evidence cause has been found.
We developed an enzymatic method using nitrocefin to assay tazobactam in vitro. Tazobactam was incubated with TEM-1 beta-lactamase. Then, residual beta-lactamase activity was assayed by adding nitrocefin. This activity corresponded indirectly to the initial concentration of tazobactam. Within-assay, between-assay and accuracy coefficients of variation were below 15%. The correlation coefficients between enzymatic method and high performance liquid chromatography (the reference method)was 0.98. The enzymatic method is rapid, easy to perform and should be applied to daily clinical practice.
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The in-vitro 50% inhibitory concentrations (IC50s) of latamoxef and imipenem against a set of plasmid-mediated beta-lactamases including TEM-1, TEM-3, TEM-5 and TEM-10 were determined by an enzymatic method using nitrocefin as substrate. The IC50s of both antibiotics against extended-spectrum beta-lactamases were below 0.2 mg/L. The conventional spectrum beta-lactamase TEM-1 was not inhibited by either antibiotic at the highest concentration tested. Except for TEM-10 for which the IC50s of the two antibiotics were the same, imipenem showed significantly greater activity than latamoxef against TEM-3 and TEM-5. Clavulanic acid taken as a control demonstrated greater and wider inhibitory activity, but on the other hand it has no significant antibiotic activity.
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This report describes the case of a woman who developed cutaneous granulomatous infiltration during childhood that was initially considered to be sarcoidosis and, after 27 years of evolution, was determined to be caused by granulomatous mycosis fungoides transforming to Ki-1-positive anaplastic large-cell lymphoma of T-cell type. We discuss the differential diagnosis, especially granulomatous slack skin and the interest of immunohistochemical and genotypic studies in this case.
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A 78-year-old woman with a history of symmetrical erythematous plaques on the arms, and a monoclonal gammopathy, developed a strange striped reticulate papular dermatosis with central atrophy. Histological examination was compatible with a very late stage of erythema elevatum diutinum (EED), showing a fibrohistiocytic proliferation with areas of granulation tissue. This fibrosis may result from the chronic dermal injury of leucocytoclastic vasculitis and is sometimes the predominant histology of EED. Investigations for underlying haematological anomalies, such as paraproteinaemia and infection with human immunodeficiency virus, must be performed. Dapsone is ineffective once the fibrous nodules have appeared.
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