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H Levenes

Publications and source records attributed to H Levenes.

9 recordsLinked to original sources
PubMed1999

The prevalence of Mycobacterium tuberculosis drug resistance in New Caledonia, 1995-1996.

SETTING: Study of the susceptibility to anti-tuberculosis drugs of Mycobacterium tuberculosis strains isolated in New Caledonia, a French South Pacific Territory, where tuberculosis continues to be a public health problem. OBJECTIVE: To assess the stability of this susceptibility in order to justify both non-systematic susceptibility testing and the implementation of simplified chemotherapy regimens. METHODS: Over a period of nearly 2 years (1995-1996), every new case of tuberculosis confirmed by the laboratory was included in the study. A total of 105 strains were tested against five anti-tuberculosis drugs: isoniazid, rifampicin, ethambutol, pyrazinamide and streptomycin. RESULTS: No primary drug resistance was detected for the main drugs. One strain with acquired resistance to isoniazid and streptomycin was isolated from one of the 12 patients suffering a relapse of the disease. CONCLUSIONS: The results of this exhaustive study justify the non-systematic approach to susceptibility testing for new patients. However, for strains isolated from patients suffering from relapse or therapeutic failure, or who belong to a high risk population, drug susceptibility testing should be performed. This kind of management will aid in the detection of possible isoniazid and streptomycin resistance, thus avoiding the selection and possible emergence of strains resistant to rifampicin. The results of the study argue for the use of a fixed dose regimen using triple combination tablets of isoniazid, rifampicin and pyrazinamide (HRZ) for 2 months, followed by dual drug therapy (HR) for 4 months.

Adolescent↗
PubMed1997

[29 cases of malaria introduced into New Caledonia from 1992 to 1995].

Although located in a tropical zone of the South Pacific, the island of New Caledonia is malaria-free. This retrospective study of imported malaria was conducted jointly by the Pasteur Institute of New Caledonia and the Gaston Bourret Territorial Hospital between January 1, 1992 and December 31, 1995. A total of 29 patients were hospitalized for malaria. Most contracted the disease in Vanuatu. Plasmodium vivax was involved more often than Plasmodium falciparum (22 vs. 11). No case was severe, complicated, or fatal. In most cases treatment consisted of quinine followed by mefloquine. The median duration of hospitalization was 5.7 days. Since the annual incidence of imported malaria is significantly higher in New Caledonia than in France, the authors propose that a Travelers Information Center should be set up in New Caledonia to improve prophylaxis against malaria.

Adolescent↗
PubMed1996

[X-ray computed tomographic and radiographic aspects of thoracic actinomycosis].

UNLABELLED: The aim of this study was to evaluate chest radiographs and computed tomography (CT) in patients with thoracic actinomycosis. MATERIAL AND METHOD: Chest radiographs and CT scans of 9 patients with proved thoracic actinomycosis were reviewed. CT scans were performed after intravenous contrast administration. RESULTS: Airspace consolidation was present in the upper lobes in 6 patients and in the lower lobes in 3. Cavitations not apparent on the radiographs were seen on CT s in 2 cases. Mediastinal lymphadenopathies were seen on CT s in 2 cases, in one the infection extended through the mediastinal pleura into the mediastinum. Pleural thickening adjacent to the airspace consolidation was identified in 6 cases. Chest wall invasion occurred in 4 cases with a wavy periostal reaction involving ribs adjacent to the site of parenchymal involvement in 3 cases. Extension into the abdomen through the diaphragm was seen in one case. DISCUSSION: In humans, actinomycosis involves the thorax in 15% of the cases. Thoracic and pulmonary parenchymal involvement is usually secondary to aspiration of colonized material from the oropharynx in patients with poor oral hygiene. There is a basilar predominance of the disease, but some studies have reported apical predominance. The pulmonary infection leads to an airspace consolidation mainly in the lung periphery. The infection may extend across fissures and through the pleura. Chest wall and bone invasion are not uncommon. A wavy periosteal reaction involving ribs is said to be highly suggestive of pulmonary actinomycosis. CONCLUSION: Thoracic actinomycosis is characterized by airspace consolidation with adjacent pleural thickening. Chest wall invasion with a wavy periosteal reaction is highly suggestive.

Actinomycosis↗
PubMed1995

[The double band sign: pleural tuberculosis in x-ray computed tomography].

We described on computed tomography, two cases of pleural tuberculosis with parietal pleural enhancement and thickening associated with another external high density line. We called this parietal pleural and extra pleural change, the "double band sign". After study of the regional anatomy, we think that this external line is the endothoracic fascia.

Humans↗
PubMed1993

[Alveolar opacities and busulfan pneumonia].

A case of toxic pneumonia due to busulfan is reported in a man aged 65 treated for three years with busulfan for chronic myeloid leukaemia. He was admitted to hospital for dyspnoea, cough, fever and presented with crepitations, dense alveolar opacities, and a restrictive ventilatory defect. Trans-bronchial biopsy showed a filling of the alveoli by fibroblastic tissue, as well as voluminous dystrophic pneumocytes. Four months later in spite of steroid therapy the clinical state and respiratory function were worse. The alveolar opacities have regressed but some diffuse interstitial opacities had appeared. This new case is a reminder that the appearance of alveolar opacities in a patient treated with busulfan should raise the possibility of a toxic pneumonitis to busulfan in the differential diagnosis. This observation also underlines the role of the initial endo-alveolar fibrosis in the ultimate development of interstitial fibrosis.

Aged↗
PubMed1992

Peripheral intramonocytic leishmanias in an AIDS patient.

Intramonocytic leishmanias were unexpectedly observed in blood smears of a Spanish AIDS patient. In immunodepressed patients from exposed countries, careful microscopic examination of blood smears should be requested by the clinician in cases of prolonged fever, and biologists must be informed that leishmanias may be fortuitously observed in the peripheral blood.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Epidemic of pulmonary histoplasmosis after visiting a cave in New Caledonia].

We report an epidemic of acute pulmonary histoplasmosis which occurred in February 1994 among a group of 24 persons after they had once or twice visited a cave in New Caledonia. This study describes the physical and laboratory findings, which lead to the diagnosis of histoplasmosis. Each test was evaluated. All members of the group had a physical examination, early and late serological tests, pulmonary X-rays (including CT) and some had mycological examination of bronchoalveolar washes. Mycological investigations were made on samples collected from the cave. Histoplasmic skin testing was not possible. We defined a case as a person who visited the cave in January 1994, had evocative radiological features and at least four symptoms among the following: weakness, fever, headache, arthralgia, thoracic pains, dyspnea, cough and nausea. Of the 24 exposed persons, 7 cases were considered as severe, 8 cases as moderate, and 6 cases as mild, for a total of 21 cases and an attack rate of 87.5%. There was no progression towards disseminated histoplasmosis and no recorded death. The incubation period lasted from 5 to 17 days. The symptoms were divided into three groups. In the first group, the symptoms of fever, headache and arthralgia were common and nonspecific. In the second group, the symptoms of chest pain, cough, and dyspnea which often occurred later, were less common and more specific. In the third group, the symptoms of vomiting, diarrhea and dizziness were less common. The chest X-ray showed abnormalities in 100% of the cases, and in 11 of the 21 cases the characteristic finding was a miliary.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMedDate not supplied

[Pulmonary dirofilariasis].

Dirofilariosis usually concerns dogs among which it is transmitted by mosquito bites. Human infection is rare and we describe here a case observed in a 75 years old woman in New Caledonia. A systematic pulmonary radiograph showed suspicious pulmonary nodules. At microscopic examination one can see pulmonary infarctus with thrombosis and Dirofilaria immitis inside a vessel. Diagnosis is usually made by histologic examination because biological investigations are of a little interest. Surgical treatment is enough. Chemioprophylaxia for dogs can reduce the risks of man infection.

Aged↗