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Biomedical subjects

E Drouhet

Publications and source records attributed to E Drouhet.

At least 37 records · Page 2Linked to original sources
PubMed1986

Comparison between magnetic enzyme-linked immunosorbent assay (MELISA) and complement fixation test (CF) in the diagnosis of paracoccidioidomycosis.

MELISA and CF were compared using sera from paracoccidioidomycosis patients before treatment and patients undergoing antimycotic treatment. With MELISA it was possible to distinguish different antibody levels in both groups of patients whereas such distinction was not observed by using CF tests. MELISA is thus an advantageous alternative to CF in the diagnosis of paracoccidioidomycosis, including the possibility of testing sera with anticomplementary activity.

Complement Fixation Tests↗
PubMed1986

[Ulcerative colitis caused by Histoplasma capsulatum in a patient with the acquired immunodeficiency syndrome].

The authors report a case of ulcerative colitis due to Histoplasma capsulatum in a previously healthy 35 year-old french geologist with acquired immune deficiency syndrome (AIDS). Gomori-Grocott and PAS stains and indirect immunofluorescence revealed Histoplasma capsulatum in colonic biopsies. The search for LAV antibody was positive. T-lymphocyte analysis revealed 10/mm3 OKT4 with OKT4/OKT8 ratio of 0.16. Histoplasmosis should be considered in subjects with ulcerative colitis according to the epidemiological context. In patients with AIDS relapses after discontinuation of treatment are to be expected and suppressive therapy with an imidazole derivative should probably be continued indefinitely.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Cutaneous, ocular, and osteoarticular candidiasis in heroin addicts: new clinical and therapeutic aspects in 38 patients.

Of 38 heroin addicts treated for systemic candidal infections, 36 had metastatic cutaneous lesions (deep-seated scalp nodules and pustulosis in hairy zones), 15 had ocular localizations (mainly chorioretinitis), and 10 had osteoarticular involvement (vertebrae, costal cartilage, knees, and sacroiliac). Such cutaneous lesions have not previously been described in classical systemic candidiasis; we also observed hair invasion by candidal hyphae. Candida albicans was the exclusive species isolated, in contrast to other visceral candidiases in heroin addicts. All isolates were sensitive to amphotericin B, flucytosine, and ketoconazole. Thirty-one visceral localizations were treated only with ketoconazole. Results were favorable in 15 of 18 cutaneous, 6 of 6 ocular, and 4 of 7 osteoarticular cases of involvement. This outbreak coincided with introduction of a new heroin on the drug market in the Paris area. C. albicans was not isolated from the drug. Pathogenesis of this syndrome is unclear.

Adult↗
PubMed1985

[Osteoarthritis caused by dematiaceous fungi. Apropos of 3 cases].

Three cases of osteoarthritis due to dematiaceous fungi are reported. The first case, a Drechslera longirostrata spondylitis complicating prosthetic valve fungal endocarditis responded only to the association of Amphotericin B and Ketoconazole. The second patient had chronic osteoarthritis of the knee due to Phialophora parasitica resistant to medical and surgical treatment after renal transplantation. These two cases are the first and the second known reports of clinical infection with these fungi. The third patient had osteoarthritis of the patella complicating a skin infection by a thorn prick. This was cured by surgical excision and 3 months' medical treatment. These cases of infections osteoarthritis of the knee followed subcutaneous abscesses. Deep tissue infections with dematiaceous fungi with osteoarthritic involvement are very rare (6 cases of Drechslera and 8 cases of Phialophora have been reported). These fungi are opportunist saprophytes of plants in subtropical regions. They are characterised on culture by their brown and black pigmentation and microscopy shows septated filaments. Cutaneous effraction is the usual portal of entry in man; patients commonly have depression of their immune systems. Osteoarthritis is generally due to local extension of a subcutaneous abscess. The functional sequellae can be very serious. Treatment comprises surgical excision of the infected tissues with antifungal drugs which may have to be given in association.

Adult↗
PubMed1984

Enzyme-linked immunosorbent assay (ELISA) in the paracoccidioidomycosis. Comparison with counterimmunoelectrophoresis and erythro-immunoassay.

An enzyme-linked immunosorbent assay (ELISA) for detection and quantification of antibodies anti-Paracoccidioides brasiliensis is described. Polystyrene plates have been used as solid phase to absorb P. brasiliensis metabolic yeast phase antigen. Twenty sera of proven paracoccidioidomycosis, 11 of histoplasmosis due Histoplasma capsulatum, 20 of aspergillosis and 20 human normal sera were tested. Ninety-five percent of the paracoccidioidomycosis sera had O.D. superior to 0.150 (from 0.163 to 2.650) at 1/400 serum dilution. ELISA assay was compared with counterimmunoelectrophoresis and erythro-immunoassay tests; a correlation was observed only with erythro-immunoassay. ELISA test should give new perspectives for the serodiagnosis of paracoccidioidomycosis.

Antibodies, Fungal↗
PubMed1984

Evaluation of auto-antibodies in chronic mucocutaneous candidiasis without endocrinopathy.

Six patients with chronic mucocutaneous candidiasis (CMCC) were investigated for the presence of auto-antibodies during the course of the infection. Sera were tested for antibodies to native DNA (dsDNA) and denatured DNA (ssDNA), mitochondrial and microsomal antigens, smooth muscle, gastric parietal cells, basal membrane and skin intercellular substance, parathyroid glands, thyroglobulin and microsomal antigen, immunoglobulins and for anti-nuclear antibodies. Auto-antibodies were detected by radioimmunoassay, immunofluorescence, hemagglutination and other routine methods. Tests were performed at the end of the observation period, with the same batches of antigens and at the same time for all patients. Organ-specific antibodies (gastric parietal cells and intercellular substance) were found at low titers in five patients. Anti-smooth muscle antibodies were increased in two patients. In four patients antibodies to ssDNA were elevated. Moreover high titers of anti-ssDNA antibodies correlated well with disease activity after treatment with Ketoconazole in four tested patients. The possibility that C. albicans infection may induce auto-antibodies should be considered in assessing their disease activity significance in other chronic infected patients. The mechanisms of appearance of auto-antibodies and their immunopathological significance in CMCC are discussed.

Adolescent↗
PubMed1984

Magnetic enzyme-linked immunosorbent assay (MELISA) for determination of specific IgG in paracoccidioidomycosis.

A magnetic solid phase enzyme-linked immunosorbent assay (MELISA) for quantification of IgG antibodies to somatic and metabolic antigens of Paracoccidioides brasiliensis was developed. Activation of magnetic polyacrylamide agarose beads with concanavalin A was superior to glutaraldehyde activation, and test sensitivity was higher for somatic than for metabolic antigens. Comparative MELISA, counterimmunoelectrophoresis and erythroimmunoassay tests with sera from 33 proven cases of paracoccidioidomycosis, 14 cases of histoplasmosis and 20 normal human sera showed the MELISA could distinguish antibody levels in paracoccidioidomycosis from those in normal sera; however two sera from histoplasmosis cases cross-reacted in the MELISA. MELISA is a rapid test (5-6 h) and the results suggest it has considerable potential value for assay of anti-P. brasiliensis antibodies.

Counterimmunoelectrophoresis↗
PubMed1984

Titration of antibodies to Paracoccidioides brasiliensis by erythro-immunoassay (EIA).

The erythro-immunoassay, a new serological procedure in which a hybrid antibody conjugate is able to bind erythrocytes, was used for the titration of antibodies against P. brasiliensis in sera from patients with paracoccidioidomycosis. A peptide-polysaccharide and a lyophilized yeast culture filtrate of P. brasiliensis were used as antigens. Absorption with dead Candida albicans whole cells was necessary to decrease cross reactions observed with heterologous sera. Erythro-immunoassay provides a sensitive system for titration of antibodies in paracoccidioidomycosis with serum dilutions up to 1:102000.

Antibodies, Fungal↗
PubMed1983

Laboratory and clinical assessment of ketoconazole in deep-seated mycoses.

Forty-eight cases of deep mycoses were studied and treated with ketoconazole, each with in vitro evaluation of the minimum inhibitory concentrations (MIC) of the causative fungi, in vivo pharmacokinetic, clinical, and mycologic evaluations, several months to two years after the treatment was stopped. Excellent results were obtained in six cases of chronic mucocutaneous candidiasis, with restoration of immunologic disturbances; 23 cases of systemic candidiasis, including new aspects of heroin addicts with cutaneous, ocular, or osteoarticular manifestations; eight cases of histoplasmosis, five due to Histoplasma capsulatum and three to Histoplasma duboisii, with cure in seven and remission in one; one case of African blastomycosis (Blastomyces dermatitidis); three cases of mycetoma, two due to Monosporium apiospermum, one due to a dematiacious fungus; three cases of entomophthoromycosis with cure; one case of fungal arthritis, due to new hyphomycete similar to M. apiospermum, pathogenic for laboratory animals; one case of Drechslera longirostrata causing vertebral arthritis, following a fungal endocarditis and cured by combination of ketoconazole with amphotericin B, each agent alone being ineffective; and other deep mycoses.

Adolescent↗
PubMed1983

[Fungal osteoarthritis of the knee with joint destruction treated with ketoconazole].

The authors report a case of acute fungal arthritis following traumatic inoculation (bramble prick) in a 9 year-old boy. The implicated fungus was an highly pathogenic atypical strain of Scedosporium (monosporium) apiospermum. Two surgical operations (synovectomy and arthrodesis) and antifungal treatment with ketoconazole led to recovery. The pathogenic role of this fungus and especially the importance of toxic phenomena are discussed. This case is compared with other in the literature. The part of ketoconazole in the recovery of this patient is emphasized.

Antifungal Agents↗
PubMed1982

[First human case of Drechslera longirostrata mycosis. Spondylodiscitis complicating prosthesis endocarditis. Treatment with combined ketoconazole and amphotericin B].

In a patient with spondylodiscitis secondary to cardiac valve prosthesis infection with endocarditis the fungus Drechslera longirostrata, which had not yet been known to cause mycoses, was isolated from cultures of prosthetic material and an intervertebral disc. The cardiac prosthesis had to be replaced and the vertebral lesion, which extended along 3 lumbar segments and was destructive enough to produce neurological disorders, required surgical immobilization of the spine. The disc infection was cured after combined administration of amphotericin B and ketoconazole, both drugs having proved unsuccessful when given alone. Infections caused by rare opportunistic fungi are becoming increasingly common and are difficult to diagnose since immunological methods are inapplicable. In some resistant or extremely severe fungal infections antifungal agents can be used in combinations for their synergistic effects, with subsequent reduction of dosage and potential side-effects. Combinations must be based on in vitro sensitivity tests.

Adult↗
PubMed1982

[New case of rhinoentomophtoromycosis. Cure by ketoconazole].

A new case of rhino-entomophtoromycosis due to Conidiobolus coronatus is added to the ten others observed in Cameroon, among the 62 african cases described. The patient, a man 27 years old, has an elephantiasis form with nasal obstruction, hypertrophy of lips, globulous forms of cheeks, giving a monstrous facies. After failure of KI and intravenous miconazole, therapeutic success was obtained with oral ketoconazole. After improvement with 400 mg daily, the doses were increased to 600 mg to obtain mycological and clinical cure with good clinical and biological tolerance; important eosinophilia related to the destruction of the fungus was observed. Restorative surgery was necessary to render a more human aspect of the monstrous lesions of face.

Adult↗
PubMed1982

[Panorama of mycoses in otorhinolaryngology].

Three classes of important mycoses in O.R.L. field can be recognized according to the responsible fungi and to thier physiopathology: 1) mycoses due to cosmopolite, opportunistic fungi, yeast-like fungi (Candida albicans, Cryptococcus neoformans, Torulopsis glabrata) or filamentous fungi (Aspergillaceae, Mucoraceae, Penicillia, etc...) invading a compromised host by antibiotics, immunosuppressors, radiotherapy or by severe diseases (hemopathia, diabetes with acidosis). The oropharyngolaryngeal candidosis, the black tongue (a polyfungal syndrome), the sinusal aspergillosis, the otomycoses, the nasalorbital cerebral form of mucormycosis are reviewed and the allergic accompanying symptoms described. 2) deep, systemic mycoses of tropical origin with respiratory entry and oral pharyngeal laryngeal metastatic localizations (histoplasmosis, blastomycosis, paracoccidioidomycosis, coccidioimycosis); the histoplasmosis represent actually the principal imported systemic mycosis with O.R.L. localization. 3) tropical and african mycosis localized exclusively in O.R.L. area (rhino-enthomophtoromycosis and rhinosporidosis).

Diagnosis, Differential↗
PubMed1982

[Histoplamosis in otorhinolaryngology].

Histoplamosis is the most frequently imported tropical mycosis observed in France. Of the cases reported in the published literature, 30 to 50 p. cent present buccopharyngeal lesions as the initial symptom revealing the presence of the disease, or forming part of a form involving multiple viscera (18.6). Since the first case reported in France in a thesis by Leger (13) in 1954, other french publications, mainly from dermatologists, stomatologists, or otorhinolaryngologists, have drawn attention to these misleading, little known buccal manifestations, that are often recognized only at a late stage (1, 4, 5, 8, 9, 10, 14, 15, 16). Five new cases treated at the Pasteur Institute Hospital are reported.

Histoplasmosis↗
PubMed1982

[Mycotic lingual granuloma. The pseudotumoral form].

Lingual candidiasis is a condition arising from a multiple of causes, some of which are well known (thrush, etc...). Two cases of chronic lingual mycotic granuloma are presented, one of which was due to a candida, the diagnosis being confirmed by pathological examination and electrosyneresis. The course of this granuloma leads to the appearance of a true epidermoid carcinoma, as illustrated by the description of other cases that have been reported. Current therapy for the granuloma itself mainly depends on the employ of ketoconazole, but the unfavorable course of the affection raises the question of the need for associated surgery.

Candidiasis↗