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Biomedical subjects

E Dournon

Publications and source records attributed to E Dournon.

At least 37 records · Page 2Linked to original sources
PubMed1987

[Borrelian meningoencephalomyelitis. A case].

A 22-year old man had spastic paraparesis and cerebellar syndrome of 5 months duration. CSF showed lymphocytosis, elevated protein content, hypoglycorachia, hypochlorurachia and oligoclonal banding. CT scan and MRI were normal. Extensive laboratory procedures disclosed no bacterial, viral, fungic, parasitic or inflammatory disease. Anti-Borrelia burgdorferi antibodies were present in blood (1/4000) and in CSF (1/1024). With antibiotics (penicillin G 20 millions units per day for 10 days, followed by latamoxef 1.5 g per day for 3 months) and prednisone (50 mg per day for 2 months), the cerebellar signs disappeared, the paraparesis improved and the CSF abnormalities disappeared; blood and CSF anti-Borrelia antibody levels decreased. This case is an example of a severe form of CNS impairment by Borrelia burgdorferi. In Europe, most reports show progressive para- or tetraparesis with, sometimes, intellectual, cerebellar or cranial nerve impairment. In some cases, the signs are less diffuse or more acute. Lymphocytic meningitis is present with hyperalbuminorachia and oligoclonal banding; hypoglycorachia is mentioned in only one other report. Diagnosis is made by high blood and CSF antibody titers and demonstration of local synthesis. As in syphilis, borrelian meningoencephalomyelitis could be the third stage of the disease. Its treatment, often disappointing, consists of antibiotics (penicillin G or latamoxef) and in some cases corticosteroids.

Adult↗
PubMed1987

Direct activation of human monocyte-derived macrophages by a bacterial glycoprotein extract inhibits the intracellular multiplication of virulent Legionella pneumophila serogroup 1.

Intracellular multiplication of virulent Legionella pneumophila serogroup 1 was inhibited by human monocyte-derived macrophages activated by a glycoprotein extract of Klebsiella pneumoniae, RU 41.740. Macrophage cultures were infected with L. pneumophila in the presence of immune antibodies on day 7 of culture. Extracellular bacteria were removed an hour after infection, and various concentrations of RU 41.740 or an antibiotic, erythromycin, were added. Intracellular multiplication in the presence of RU 41.740 was significantly slowed down compared with that of cultures without RU 41.740. The reduction was, however, significantly less than that effected by erythromycin, which was used as a positive control for inhibition of intracellular multiplication. Cultures incubated with RU 41.740 before infection also demonstrated a significant reduction in the intracellular multiplication of L. pneumophila. In addition, RU 41.740 increased superoxide anion production from human monocytes in suspension in the presence of L. pneumophila. These results show that direct nonspecific activation of macrophages by a bacterial glycoprotein inhibits the intracellular multiplication of L. pneumophila and may suggest a role for activated macrophages in host defense against intracellular pathogens.

Bacterial Proteins↗
PubMed1987

Evaluation of sensitivity of two serological tests for diagnosing pneumonia caused by Legionella pneumophila serogroup 1.

The sensitivity of an indirect immunofluorescence antibody test (IFAT) and a rapid microagglutination test (RMAT) for the diagnosis of Legionnaires' disease caused by Legionella pneumophila serogroup 1 was evaluated using serum specimens from 119 patients with bacteriologically confirmed infections. The sensitivity of both assays was found to be about 80%. In addition, antibody titres suggestive of L pneumophila infection were found in 40% of patients in the first week after admission to hospital. These data show that both assays can be used with confidence in the early diagnosis of Legionnaires' disease.

Adolescent↗
PubMed1987

Legionnaires' disease after bone marrow transplantation.

Four patients developed legionnaires' disease after bone marrow transplantation. Two cases occurred early after transplant and were considered as part of a hospital epidemic due to contamination of water supply. The other two cases were considered to be sporadic because they occurred 3-4 weeks after hospital discharge. The outcome was good in two patients. In the third patient, recurrent disease was probably due to acquired resistance to macrolides, and complete cure was achieved after treatment with pefloxacin and rifampicin. The fourth patient died of overwhelming infection despite early treatment with erythromycin and pefloxacin. During the same period we treated 14 patients with pefloxacin for prevention of bacterial infection, of whom none developed Legionella pneumophila infection, while three of the patients reported here were in a group of 11 patients who received only oral non-absorbable antibiotics for gut decontamination. The fourth patient in this report was receiving no antibiotics. Thus pefloxacin seems to be effective as prophylaxis against L. pneumophila infection. When the hospital water supply was heated to 60 degrees C and chlorinated, the nosocomial cases in the hospital completely disappeared.

Adult↗
PubMed1987

[Severe jaundice in Legionnaires' disease: a case with early hepatic biopsy].

Although liver tests are frequently disturbed in Legionnaires' disease, jaundice occurs rarely except as a terminal event. The authors report the case of a 68 year-old man with jaundice as a presenting feature of the disease. Jaundice deepened rapidly until death a few days later. Drugs and other causes of cholestasis could be ruled out. An early liver biopsy was performed. The liver was histologically normal except for mitochondrial margination in the hepatocytes. No Legionella could be demonstrated by direct fluorescent assay. These findings suggest that: jaundice in Legionnaires' disease is not related to direct bacterial insult, cholestasis is probably consecutive to endotoxinemia, the mitochondrial margination, a rare histologic finding, could result from Legionnaires' disease. This last point needs confirmation by further studies.

Aged↗
PubMed1987

[Tonsillitis today. Epidemiologic review. Clinical correlates. Therapeutic impact].

A prospective study was conducted in 216 patients with ulceration of throat and 100 controls. Bacteriology showed, in the low percentage of case with positive results, the classical distribution of germs generally identified from throat swabs, with predominance of haemolytic streptococci AB and associated fusospirilla. Haemophilus influenzae was very rarely isolated (1%) and immunofluorescence tests for Chlamydia trachomatis in the pharyngeal exudate were always negative, in both patients and controls. These findings confirm utility of Penicillin V as single therapeutic agent in ulcerated throat. Correlations between clinical findings and between these and bacteriology results demonstrated that clinical examination failed to provide data contributive to the establishment of an aetiological diagnosis and therefore to treatment, which, in the absence of complementary examinations, must remain empirical.

Adolescent↗
PubMed1986

Efficacy of pefloxacin in comparison with erythromycin in the treatment of experimental guinea pig legionellosis.

Pefloxacin was compared to erythromycin in the treatment of guinea pigs severely infected with Legionella pneumophila. In this experimental model, two single intraperitoneal injections of either pefloxacin (10 mg/kg at 48 h and 5 mg/kg at 55 h) or erythromycin (40 mg/kg at 48 and 55 h) were administered 48 h post-infection (2 X 10(7) virulent L. pneumophila intraperitoneally). Counts of bacteria in blood monocytes and lungs of animals killed at different times after the completion of treatment, demonstrated a quick and highly significant reduction of the pretreatment bacterial load in pefloxacin-treated guinea pigs. Conversely, in erythromycin-treated animals the number of bacteria was only slightly reduced 17 h after the completion of the treatment and then multiplication up to pre-treatment levels occurred. The overall mortality was significantly lower in pefloxacin-treated animals with this therapeutic protocol. The remarkable results of pefloxacin in this model, were obtained with serum and lung levels of this drug lower than those achieved in man with the currently accepted regimens. Thus, pefloxacin appears to be a new promising antimicrobial agent for Legionnaire's disease.

Animals↗
PubMed1986

Inhibition of Legionella pneumophila multiplication within human macrophages by antimicrobial agents.

The activity of serial concentrations of different antimicrobial agents on the multiplication of Legionella pneumophila within human monocyte-derived macrophages was studied. The results led to the definition of a minimal extracellular concentration inhibiting intracellular multiplication (MIEC). According to the MIECs, the antimicrobial agents tested were classified in three groups: very active (MIEC less than or equal to 0.06 microgram/ml), such as erythromycin, rifampin, and pefloxacin; active (1 microgram/ml greater than or equal to MIEC greater than or equal to 0.1 microgram/ml), such as sulfamethoxazole-trimethoprim or doxycycline; and ineffective, such as cefoxitin, which was not active within macrophages at as high as 64 micrograms/ml despite a low MIC (0.2 microgram/ml) on bacterial charcoal-yeast extract agar. The activity of netilmicin was difficult to assess because of its effect on extracellular legionellae. Combinations of erythromycin with rifampin and pefloxacin with erythromycin, rifampin, doxycycline, or netilmicin showed an additive effect and no antagonism. These results obtained in a cellular model are in agreement with the efficacy of antimicrobial agents in experimental infections and in Legionnaires disease. They sustain clinical interest in the new quinolones, such as pefloxacin, and in combinations of antimicrobial agents for the treatment of Legionnaires disease.

Anti-Bacterial Agents↗
PubMed1986

[Association of bacterial endocarditis and alcoholic cirrhosis in 9 patients].

Ten cases of bacterial endocarditis were observed in cirrhotic patients. In 7 cases, endocarditis was due to group D Streptococcus, 5 of which were Streptococcus D. bovis. Special features were the involvement of tricuspid valve and the involvement of two or more valves in 4 cases. Surgery was necessary in the acute phase in 5 patients: cure was definitely obtained in 8 cases after a particularly long interval. A colonic lesion could have been the portal of entry in some cases. Liver cirrhosis was considered as a predisposing factor for bacterial endocarditis, especially due to group D Streptococcus or to other bacteria of intestinal origin. This is probably related to the frequency of the colonic origin of group D Streptococcus endocarditis. Loss of filter function of the liver may partly explain the features of these forms of endocarditis.

Adult↗
PubMed1986

[Lyme disease. Apropos of a case in children].

A case of Lyme disease with purely neurological manifestations is reported in an 11 year-old girl. Positive blood and cerebrospinal fluid serology allowed for diagnosis. Treatment with Penicillin led to favourable outcome. Atypical manifestations and treatment of Lyme disease are reviewed.

Child↗