[Infectious and parasitic diseases: overview of current status in 1979].
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Biomedical subjects
Publications and source records attributed to J Frottier.
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The current frequency of road accidents leads to the necessity to seek a possible head injury in the past history of patients suffereing from acute purulent meningitis. This investigation must be all the more assiduous in the presence of a meningitis which is pneumococcal in origin and recurrent. Rhinorrhoea is a sign of primary importance. Tomography of the frontal and sagittal views of the skul remains of value. Radio-isotope studies of the CSF happile make up for the deficiencies of radiological examination, without providing an infallible means for the detection of osteomeningitis defects. The authors report their findings and therapeutic results in 16 patients collected in a series of 162 cases of acute purulent meningitis.
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Bacterial infections are the most common cause of death in patients with malignant blood diseases. After recalling the main bacteria responsible and the factors which predispose patients to infection, the authors consider various forms of treatment, including antibiotic therapy, transfusions of white blood cells, gammaglobulins, etc., and prophlyactic measures, such as antibiotics by mouth, isolation in a sterile ward, etc., which have been proposed for some years. During renal grafts, infective complications are also very frequenct. Their prevention is essential for on this, to a large extent, depends the success of the transplantation.
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During bacterial infections, the intensity of the polymorphonuclear leukocytosis depends on the bacterium but also on the mechanism and extent of the infection. Polymorphonuclear leukocytosis is greater during pyogenic and anaerobic infections. It is due to deep suppuration, septicemia of thrombophlebitic origin, acute endocarditis, purulent meningitis and pneumonia. The increase in the number of polymorphonuclear cells is, on the other hand, less marked in sub-acute bacterial endocarditis. Apart from bacterial infections, a polymorphonuclear leukocytosis is common in inflammatory disease, such as tissue necrosis and several malignant diseases. It may also be due to drug allergy.
A young woman aged 23 showed the clinical feature of relapsing polychondritis. This disease included recurrent inflammation of right ear, nasal rib and larynx cartilages. She had also arthritis of ankle and wrist. She never had aphtosis before her cartilaginous disease. Buccal and genital erosions similar to aphtae occurred before each recurrent attack of cartilage inflammation. In one instance aseptic vesiculo-pustular and erythema nodosum like lesions occurred. This case raises the question of whether this is a never reported association of two diseases or relapsing polychondritis may have dermatological symptoms bordering aphtosis. The latter hypothesis is supported: firstly by the fact that skin symptoms of aphtosis had been reported separately in cases of relapsing polychondritis (buccal aphtae, pustular eruption, erythema nodosum, recurrent thrombophlebitis); secondly by a case very similar to our (Thivolet, see text) showing a typical feature of relapsing polychondritis with a complete dermatological aspect of aphtosis.