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Biomedical subjects

J Bogaerts

Publications and source records attributed to J Bogaerts.

At least 73 records · Page 4Linked to original sources

Bacteraemia as predictor of HIV infection in African children.

In Rwanda, both HIV infection and bacteraemia represent major health problems among paediatric populations. We carried out of prospective study of determine if bacteraemia is a marker of HIV infection among ambulatory and hospitalized Rwandese children. All children presenting at the Department of Paediatrics of the Center Hospitalier de Kigali who had their blood cultured during a two-month period were eligible for the study. One hundred and thirty-five children were included in the study. A pathogen was isolated from 36 children (26.7%): S. typhimurium (10 cases), S. enteritidis (6), S. typhi (4), Str. pneumoniae (9). H. influenzae (6) and S. aureus (1). No association was found between bacteraemia and HIV seropositivity when all the children were considered. However, among patients less than 2 years old, bacteraemic subjects were more frequently (p less than 0.05) HIV seropositive (44%) than those with negative blood cultures (19%). Our study shows that in young children in Central Africa, the presence of bacteraemia may be an important marker of HIV seropositivity.

Acquired Immunodeficiency Syndrome↗

Single-dose cefotaxime intramuscularly cures gonococcal ophthalmia neonatorum.

Nine neonates with culture proved gonococcal ophthalmia neonatorum were treated with a single intramuscular injection of 100 mg/kg of cefotaxime without topical antibiotic therapy. Five of the nine strains were penicillinase-producing Neisseria gonorrhoeae. All nine cases were clinically and microbiologically cured, and no side effects were observed.

Cefotaxime↗

Herpes zoster in African patients: an early manifestation of HIV infection.

During a 3-month period, 131 cases of herpes zoster were diagnosed in Kigali, Rwanda. There were 46 female and 85 male patients. Mean age was 29 years (range 1-66). An unusually high proportion of patients presented with cranial and sacral nerve localisation of their cutaneous lesions. 55/131 patients (42%) had involvement of more than one dermatome. None of the patients had an underlying condition known to favour herpes zoster. 120/131 (92%) had antibodies to HIV detected by an immunoenzymatic assay (EIA) and indirect immunofluorescence. 92/125 adult patients (74%) had no sign or symptom related to HIV infection other than herpes zoster. This study suggests that herpes zoster in Central Africa is an early and readily detectable manifestation of HIV-induced immunosuppression.

Adolescent↗

Community-acquired bacteraemia in African children.

To examine the frequency of community acquired bacteraemia in children in Kigali, Rwanda, blood cultures were obtained from 900 consecutive febrile children (T degrees greater than or equal to 39 degrees C) seen at an outpatient clinic over the course of a year. A pathogen was isolated from 112 children (12.4%): Salmonella typhi from 47, S enteritidis from 23, S typhimurium from 13, Streptococcus pneumoniae from 14, Staphylococcus aureus from 9, and Haemophilus influenzae from 3. Salmonella species represented 74% of the isolates. The children with S typhi bacteraemia were older (mean age 75 months) than those with bacteraemia due to other organisms. Controls consisted of febrile, nonbacteraemic children without (group I) or with (group II) Plasmodium falciparum parasitaemia. Bacteraemic children were older and presented more frequently with diarrhoea, vomiting, and dehydration, but less frequently with convulsions than controls. The rate of hospital admission was higher among bacteraemic children (61%) than among group I (39%) or group II (46%) controls. The case-fatality rate was similar in the three groups (9.3% versus 2.9% and 7.3%). Community-acquired bacteraemia in Rwandese children is common and is mainly caused by Salmonella species.

Age Factors↗

Ovarian actinomycosis during first-trimester pregnancy.

A case of actinomycotic ovarian abscess ruptured during early gestation and related to IUD use is reported. The patient was treated by antibiotic therapy and oophorectomy. Further evolution of the pregnancy was irrelevant.

Abscess↗

Norfloxacin versus thiamphenicol for treatment of uncomplicated gonorrhea in Rwanda.

In an open prospective study, single oral doses of norfloxacin (800 mg) and thiamphenicol (2.5 g) were used to treat, respectively, 122 and 46 consecutive patients with uncomplicated gonorrhea. Neisseria gonorrhoeae was eradicated from 119 (97.5%) patients treated with norfloxacin and from 35 (76.0%) patients treated with thiamphenicol. Norfloxacin treatment failure was not related to drug resistance or to insufficient absorption of the drug. Thiamphenicol failure correlated with low in vitro susceptibility of the infecting strain. In a single oral dose of 800 mg, norfloxacin appeared to be an excellent alternative treatment regimen for uncomplicated gonorrhea in an area with a high prevalence of penicillin-resistant gonococci.

Female↗

Metastatic focal infections due to multiresistant Salmonella typhimurium in children: a 34 month experience in Rwanda.

Nineteen out of 139 children with severe systemic disease due to multiresistant Salmonella typhimurium observed during a 34-month period in an in-patient department in Rwanda had focal metastatic infections. More than 80% of the invasive Salmonella infections were acquired in the hospital. Focal metastatic infections occurred after longer hospital stays than bacteremia (29.1 +/- 17.4 days as against 13.5 +/- 9.0 days, p less than 0.01) and were diagnosed more time after the first sign of infection (3.28 +/- 1.41 days as against 1.86 +/- 1.10 days, p less than 0.01). Bacteremia was documented in 13 of the 17 children with focal infection from whom blood cultures were obtained. Seven of 12 had positive stool cultures. The sites of metastatic focal infection were meninges (7 cases), soft tissue (5 cases), joint or bone (4 cases), pleura (2 cases), eye (1 case). The clinical course of meningitis was fulminant and 6/7 patients died before receiving adequate antimicrobial therapy. One child with meningitis and 9 patients with focal infections at other sites were treated with cefotaxime and were cured or improved.

Child↗

In vitro antimicrobial sensitivity of Neisseria gonorrhoeae from Rwanda.

The in vitro sensitivity of 104 isolates of Neisseria gonorrhoeae to six antimicrobial agents was tested. More than 50% of the isolates produced penicillinase. Of those that did not produce penicillinase, 26% were resistant (minimum inhibitory concentration (MIC)) greater than or equal to 0.5 mg/l), and 68% showed a decreased sensitivity for penicillin G (0.06 less than or equal to MIC less than or equal to 0.25 mg/l). Twenty six per cent and 50% of the strains, respectively, showed a decreased sensitivity to thiamphenicol (MIC greater than or equal to 1 mg/l) and tetracycline (MIC greater than or equal to 2 mg/l). All isolates were sensitive to spectinomycin, kanamycin, and norfloxacin. Of 20 penicillinase producing N gonorrhoeae (PPNG) isolates examined, seven contained the 3.4 megadalton R-plasmid, another seven contained both the 3.4 megadalton and 22.5 megadalton plasmids, five the 4.3 megadalton and 22.5 megadalton plasmids, and one isolate harboured both the 3.4 and 4.3 R-plasmids, together with the 22.5 megadalton plasmid. A disturbing increase in resistance to penicillin has been observed since the publication of earlier surveys, and the clinical implications of these findings are discussed.

Anti-Bacterial Agents↗

A prospective study of the ophthalmologic findings in the acquired immune deficiency syndrome in Africa.

A prospective study of ophthalmologic findings in 20 African patients with the acquired immunodeficiency syndrome (Group 1) and nine patients with acquired immune deficiency syndrome related complex (Group 2) disclosed that 11 patients in Group 1 and two patients in Group 2 had ocular involvement. Cotton-wool spots, Roth spots, and hemorrhages were frequent features in Group 1. In this series, unlike most others, perivasculitis occurred in five patients whereas cytomegalovirus retinitis and ocular involvement of Kaposi's sarcoma were not observed. These African patients also differed from those previously described in the high proportion of women (11 of 29) and the lack of the usual risk factors (homosexuality, intravenous drug abuse, and hemophilia).

Acquired Immunodeficiency Syndrome↗

Severe respiratory infection with Branhamella catarrhalis in an African child.

A pure growth of Branhamella catarrhalis was obtained from a purulent bronchial exudate in a 28-month-old Rwandese girl, hospitalized for acute inspiratory dyspnoea with fever. The outcome was favourable under treatment with ampicillin, although the isolate was shown to produce a beta-lactamase in vitro.

Ampicillin↗