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E Caumes

Publications and source records attributed to E Caumes.

At least 19 recordsLinked to original sources
PubMed2002

[Legionellosis in HIV-1 infected patients. 4 case reports].

INTRODUCTION: Contrary to patients exhibiting cellular immunodepression, legionellosis is rare in HIV-infected patients. We report 4 cases. OBSERVATIONS: Four men aged 41 to 48 were infected by HIV-1. Three of them were treated with antiretroviral therapy. The clinical and biological manifestations were unspecific. Evolution was favourable with adapted antibiotic therapy (erythromycine for three patients and ciprofloxacine for the fourth). COMMENTS: Legionella pneumophila serotype Lp1 remains the principle etiological agent. Frequent use of contrimoxazole in prophylaxis against pneumocystosis and toxoplasmosis, macrolides, rifamycines and fluoroquinolones in the preventive and curative treatment of mycobacterioses, and the relative conservation of monocyte/macrophage function and immune repair with efficient antiretroviral therapy, may explain the low prevalence of this disease in HIV infections.

AIDS-Related Opportunistic Infections↗
PubMed2002

[Current clinical aspects of HIV/AIDS].

OF NEW CLINICAL DEMONSTRATIONS: Since the use of HAART, morbidity and mortality in HIV-infected patients have decreased dramatically. But increased survival in these patients is associated with other diseases (malignant diseases, inflammatory reactions after initiation of HAART) and with drug toxicity (lipodystrophy, mitochondrial toxicity). TRANSMISSION AND REVELATION: Despite widespread information on HIV, new HIV-infected patients with an AIDS-defining illness are still detected. At present, heterosexuality is the most frequent risk factor for HIV-infection (51%). Pneumocystis pneumonia remains the most common opportunistic illness in HIV-infected patients (28%).

AIDS-Related Opportunistic Infections↗
PubMed2002

Cutaneous larva migrans with folliculitis: report of seven cases and review of the literature.

Seven patients (four men, three women, mean age 31 years), all returning from the tropics, presented with pruritic folliculitis and creeping eruption. The folliculitis consisted of 20-100 follicular papules and pustules confined to a particular area of the body, mainly the buttocks. The creeping eruption consisted of two to 10 serpiginous or linear burrows 1-5 cm long located either in the same area or in a different area from the folliculitis. Five patients were cured with one to three courses of ivermectin (one course in two cases, two courses in two cases and three courses in one case) and two patients were cured with a 3-day regimen of albendazole. Folliculitis should be added to the dermatological manifestations of cutaneous larva migrans. Treatment is more difficult than in classical forms of cutaneous larva migrans.

Adult↗
PubMed2002

[Current data on malaria in metropolitan France].

Epidemiological data from the French National Reference Center for Imported Diseases showed that the estimated number of cases of imported malaria in France increased from 5,940 in 1998 to 7,127 in 1999 and 8,056 in 2000. This three-year progression ended in 2001 when the number of estimated cases fell back to 7,223. It was due mainly to the concomitant increase in the number of people traveling to endemic zones especially in Africa. In 2000 the median age of patients with imported malaria in France was 29.5 years and the sex ratio was 1.78. Sixty-three percent of cases involved people of African origin and 37% involved "Westerners". The countries in which contamination occurred were located in tropical Africa (95%), Asia (2.2%), and Latin America (2.7%). During the three year period from 1998 to 2000, there were a total of 13 accidental autochtonous cases of malaria involving patients with no history of travel to tropical areas. The distribution of Plasmodium species involved in imported malaria in France was stable with 83% of cases involving Plasmodium falciparum, 6% involving Plasmodium vivax, 6.5% involving Plasmodium ovale and 1.3% involving Plasmodium malariae. Attacks were clinically uncomplicated in 90 to 95% of cases and severe in 2 to 5% including fatal Plasmodium falciparum malaria in 0.49 to 0.37% of cases. Less than 10% of the 45% of patients claiming use of prophylaxis complied properly. Analysis of the drugs used for curative treatment in 2000 showed an increase in the use of quinine and mefloquine and decrease in the use of halofantrine. The main objectives remain reduction of mortality and improvement of prevention.

Adolescent↗
PubMed2001

Clinical and virologic characterization of acyclovir-resistant varicella-zoster viruses isolated from 11 patients with acquired immunodeficiency syndrome.

We studied the clinical resistance to acyclovir of infections with varicella-zoster viruses (VZV) in patients with acquired immunodeficiency syndrome, and we correlated it to virologic analyses. Eleven patients with VZV infections (treated with acyclovir, 30 mg/kg/day, given intravenously, or 4 g/day, given orally) were included in the study because of the failure of 10 days of acyclovir therapy. Susceptibility of VZV isolates to acyclovir was tested using a plaque reduction assay to determine the 50% inhibitory concentration (IC(50)) of acyclovir and the SI(50) (IC(50) of the patient isolate/IC(50) of the reference strain) to acyclovir. The thymidine kinase (TK) gene, which supports the resistance, was sequenced on amplified products. Only 3 patients had a significant increase in the IC(50), as compared with the IC(50) of the reference strain (SI(50) of > or =4), and a mutation in the TK gene. For the other 8 patients, the clinical resistance was not confirmed by the virologic results: the SI(50) was < 4, and no mutation was detected in the TK gene. Because no acyclovir-resistant strain appeared during a shorter period of time, we suggest an increase in the duration of the treatment to 21 days before acyclovir resistance is suspected.

Acyclovir↗
PubMed2001

Subacute clinical forms of Plasmodium falciparum malaria in travelers receiving chloroquine-proguanil prophylaxis.

We have observed 4 French travelers, returning from African countries, who were not immune to malaria and were receiving chloroquine-proguanil prophylaxis, in whom the diagnosis of malaria could easily have been missed because the clinical signs were uncommon. These cases suggest that chloroquine-proguanil prophylaxis is not always effective and that travelers with unexplained symptoms should be monitored closely for malaria.

Adult↗
PubMed2001

[Fainting after drinking a glass of whiskey-soda...].

BACKGROUND: Alcohol intolerance is a rare syndrome that usually involves pain, pruritus, or vasomotor phenomena consecutive to moderate alcohol intake. This syndrome may unmask various malignancies, especially Hodgkin's disease or non-Hodgkin lymphoma, and carcinoma of the cervix. CASE REPORT: A patient who became unconscious after drinking a glass of whiskey-cola was explored for alcohol intolerance. High-level hypereosinophilia was discovered. The diagnosis of idiopathic hypereosinophilia was retained after extensive evaluation. DISCUSSION: Idiopathic hypereosinophilia may be a premalignancy expression of a lymphoproliferative disorder. In our patient, who also had alcohol intolerance known to be associated with later diagnosis of malignancy, lymphocyte phenotype studies revealed an abnormal population. However, rearrangement studies of T-cell and B-cell receptors, as well as bone marrow cytology and histology did not enable identification of a lymphoproliferative disorder. This patient will require close follow-up due to the risk of developing a lymphoproliferative disorder.

Abdominal Pain↗
PubMed2001

[New indications of ivermectin].

INTRODUCTION: Ivermectin is a semi-synthetic derivative of a family of macrocyclic lactones. This drug has a broad-spectrum anti-parasitic effect against various nematodes and ectoparasites. CURRENT KNOWLEDGE AND KEY-POINTS: Onchocerciasis and lymphatic filariasis are common indications. More recently ivermectin has been recommended in the treatment of strongyloidiasis and scabies. FUTURE PROSPECTS AND PROJECTS: Promising results have been shown in the treatment of ascariasis, cutaneous larva migrans, loiasis and head lice.

Antiparasitic Agents↗
PubMed2001

[Epidemiological features and incidence trends of primary cerebral lymphomas observed in 80 HIV-infected patients from 1983 to 1999].

OBJECTIVE: To describe the epidemiological characteristics of primary central nervous system lymphoma (PCNSL) and the evolution of the incidence of this lymphoma in HIV-infected patients with a more than 17-year follow-up. RESULTS: Eighty cases of PCNSL were analyzed from a data base of 2,263 AIDS subjects followed from 1983 to 1999 (3.5% of the patients with AIDS). At the time of diagnosis, PCNSL was the first AIDS defining event in 36% of the cases, median CD4 count was 9/mm3 (0-134); 82% of the patients were given antiretroviral therapy (HAART = 0). Only eight cases of PCNSL were observed after 1996 (median HIV RNA level: 250,000 copies/mL (24,000-1,500,000)). The incidence was 39 per 100 patients-year in 1991 and decreased to 1.9 in 1999. At the end of the study, 78 patients had died (98%). The median survival was one month before 1996 ([0-27], n = 72), and was ten months after ([0-44], n = 8). Two patients were still alive 38 and 44 months after diagnosis. After 1996, survival was increased in patients with good response to antiretroviral treatment and in patients with high CD4 count at the moment of diagnosis. CONCLUSION: After the introduction of HAART (1996), the incidence of PCNSL has decreased drastically and survival was increased.

Adult↗