Biomedical subjects
Publications and source records attributed to B de Labarthe.
The authors observed a pulmonary alvelolar proteinosis in an 11 years old child with acute leucosis. They underlined the exceptional character of this association in a child, while it is known in the adult and almost always with a bad prognosis. A dysimmunity context linked to a hematological disease and/or its treatment, is favoured among the pathogenic hypotheses.
The authors report a case of severe obliterating laryngo-tracheo-bronchitis without any evident etiology in a young patient with depressed immunity. A herpetic virus was isolated by distal bronchial brushing and by larynx biopsy. The level of specific antibodies rose significantly. These facts together with the clinical history and unsuccessful microbiological searches, suggest the herpetic nature of this affection, albeit exceptional. At this opportunity, a review of the literature is presented showing the imprecision of diagnostic criteria in this field of pathology.
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The authors report a case of lethal acute miliary with bovine tuberculous bacilli. They stress the main characteristics of this exceptional observation :--difficulties in isolating and identifying,--favourable disposition linked to age and to a depressed cellular immunity,--pathogenic interest in the mechanisms of late endogenous reinfestation and of suffocating acute evolution.
The tubercle bacillus was sought in samples obtained by bronchial brushing in 36 patients whose tuberculosis was demonstrated and in whom a direct examination of the sputum had given only negative results. In 5 cases, the tubercle bacillus was demonstrated only in the sample obtained by brushing, by direct examination and positive cultures in one case and in the other cases, culturutum coughed up after brushing.
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The authors analyse the pulmonary symptoms found by X-Ray in nine immunodepressed patients who were hosts to Pneumocystis carinii. The radiological abnormalities do not generally appear early nor are they specific; the syndrome of diffuse alveolar consolidation only appears at a late stage, it is most serious in the base and the peri-hilar regions, but does not affect the apex. It would appear that no prognostic value can be ascribed to the radiological results. The authors therefore suggest bronchial scanning for tracking down the Pneumocystis whenever suspicious clinical symptoms appear.
This clinical trial of fenspiride (injectable and sustained-release 80 mg tablet) was carried out on patients selected because their bronchopathy was of a hypersecretory type. Interesting results were observed in 20 out of 37 cases, but they were often delayed. This group of patients included a high proportion of patients with major hypersecretion; the efficacy of fenspiride is often evident, (in 8 out of 11 cases) but it is unpredictable individually. It can be concluded from this trial that a long term treatment with fenspiride, well tolerated, can usefully be tried in patients with predominant signs of bronchial hyperexudation.
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