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J L Vilde

Publications and source records attributed to J L Vilde.

At least 91 records · Page 5Linked to original sources
PubMed1984

[Pseudomonas aeruginosa meningitis treated with azlocillin. 5 cases].

Prior to the introduction of new beta-lactam antibiotics, such as ureidopenicillins and some third generation cephalosporins, the choice of antibiotics for the treatment of meningitis caused by Ps. aeruginosa was limited, and even now, this infection remains of poor prognosis. Five patients with meningitis, aged from 18 to 75 years, were treated with azlocillin. The strains of Ps. aeruginosa isolated were all sensitive to azlocillin, the zones of inhibition being greater than 20 mm in diameter with bacteriostatic concentrations. Azlocillin was administered 8-hourly by intravenous injection in doses of 30 g/day in 3 cases and 15 g/day in 2 cases. The mean duration of treatment was 33 days (range 23-50 days). In addition to azlocillin 4 patients received an aminoglycoside (tobramycin or amikacin) parenterally and, in one case, intrathecally. Four patients underwent a surgical operation on the focus of infection between the 9th and 13th days of treatment. In 3 of these 4 patients surgery was necessary to obtain apyrexia, but in all cases the CSF was already sterile when it was performed. The outcome was favourable in all 5 cases. One patient relapsed on 4 occasions due to persistent petrous bone fistula; each time, the azlocillin treatment was reinstituted and brought about clinical and bacteriological cure. The germ was eradicated in CSF on the 3rd day of treatment in 3 patients and on the 7th day in one. One patient developed transient eosinophilia and another, transient neutropenia after 30 days. It is concluded that azlocillin, associated with an aminoglycoside, is an active and effective antibiotic for the treatment of Ps. aeruginosa meningitis.

Adolescent↗
PubMed1984

Late prosthetic valve endocarditis. Bacteriological findings and prognosis in 29 cases.

Of 296 incidences of infectious endocarditis seen between 1971 and 1980, 29 cases of late prosthetic valve endocarditis (10%) occurred in 26 patients who had undergone valve replacement more than two months previously. The prosthesis was mitral in 8 cases, aortic in 9 cases, and multiple in 12 cases. The clinical picture consistently associated fever together with a regurgitation murmur in 12 cases (41%), a splenomegaly in 7 cases, a neurologic accident in 13 cases and other signs of endocarditis in 10 cases. Blood cultures were positive in 28 cases. The diagnosis was confirmed anatomically in 11 cases. Thirty-one causative agents were identified: 15 streptococci (48%), most of them were group D (11/15), 11 staphylococci (35%) 6 Staphylococcus aureus, 5 Staphylococcus coagulase negative and 5 other species. Two relapses and 3 recurrent infections were noted. The death rate was 58% with some factors being associated with a higher death rate: non-streptococcal micro-organism (87%) regurgitation murmur (83%) cardiac failure with dysfunction of the prosthesis (89%) neurologic complication (91%). Eight valve replacements were performed within a mean period of 32 days after the onset of the antibiotherapy with a death rate of 75%. It decreased to 50% for patients treated with antibiotic alone, and as low as 23% for Streptococcal endocarditis. These results suggest that earlier and more frequent indications for cardiac valve replacement could be an alternative to improve the prognosis.

Endocarditis, Bacterial↗
PubMed1984

[West Nile virus meningomyeloencephalitis--value of interferon assays in primary encephalitis].

A 68 year-old woman contracted West Nile fever after a stay of one month in Israel. Mild encephalitis and severe myelitis, resembling the "polio syndrome", developed, with important sequelae. Specific antibodies against West Nile fever virus progressively increased in the patient's serum. Epidemiological and clinical data about neurologic aspects of this infection are reviewed. Meningoencephalitis is not unusual, but only one previous case of acute anterior myelitis has been described in humans although this pathology is well known in experimental and veterinary diseases. Very few studies concern interferon and arbovirus infections in humans. Interferon assays in our patient's serum and cerebrospinal fluid showed its presence and persistence: this is in relation with the replication of the virus in the central nervous system, as it has been demonstrated in other primary viral encephalitis.

Aged↗
PubMed1983

Comparative use of adenine arabinoside and adenine arabinoside monophosphate in varicella and disseminated zoster in immunosuppressed patients.

Adenine arabinoside monophosphate (ARA AMP) was used in ten immunosuppressed patients suffering from varicella or disseminated zoster, and compared to adenine arabinoside (vidarabine) in ten other similar patients. Good results were obtained with both drugs: the fever stopped suddenly in three or four days and no new vesicles were observed after the third day. ARA AMP is more soluble than vidarabine and is thus easier to handle; it could be an effective treatment of severe varicella-zoster virus infections in immunosuppressed patients.

Adult↗
PubMed1983

[Infectious arteriopathies].

After reviewing the physiopathology, the authors report the principal features of infectious arterial disease observed in a department of infectious diseases. Excluding iatrogenic arteritis, particularly after vascular surgery, and some vasculitis in which an infectious agent may play a role, only the classical but now rare causes are described: rickettsial disease, syphilis and typhoid. The most commonly observed problem at present is infectious aneurysms: primary aneurysms secondary to atherosclerosis in which salmonella is by far the predominant organism, before the staphylococci and streptococci. The most serious complication is the major risk of rupture which may be the presenting event. Secondary aneurysms are essentially those of endocarditis. The mechanism is not fully understood and they occur at different stages of the course of the disease. The main problem associated with these aneurysms is their multiplicity and localisation; the intracranial forms are the most common and most serious in the experience of the authors, with their difficulties of diagnosis and treatment: extracranial aneurysms are usually located in the main limb arteries. Adjacent secondary aneurysms are exceptionally rare. Tuberculous and viral causes of aneurysm are among the rarest etiologies discussed.

Adult↗
PubMed1982

[Endocarditis due to commensal Neisseria (author's transl)].

Three cases of endocarditis due to Neisseria mucosa are reported. The pathogenic role of these commensal microorganisms is reviewed. A survey of the literature found a dozen cases of endocarditis due to commensal Neisseria before the antibiotic era, and fourteen more since then (not including our three observations). Some of distinctive features can be delineated from the study of cases seen during the second period. Patients mean age is fairly low (34 years), incidence of cutaneous manifestations is high, and vascular complications (mainly embolism) are common (52, 1% of the cases). Overall prognosis is good and the recovery rate (82 %) is similar to that seen in non-D Streptococcus endocarditis.

Adolescent↗
PubMed1981

[Asiatic dengue in France: 9 cases, of which one of the thrombopenic type (author's transl)].

Asiatic dengue was detected in nine tourists. In eight patients it was of the classical benign type, the ninth case being associated with severe thrombopenia (4 000/mm3), but without signs of shock. A brief summary is given of the physiopathology of the hemorrhagic forms of the disease: acquired sensitivity from a primary attack and reinfection with a heterologous virus; selection of virulent strains by an atypical vector; genetic recombination producing a strongly pathogenic virus.

Adult↗
PubMed1980

Lactoferrin deficiency as a consequence of a lack of specific granules in neutrophils from a patient with recurrent infections. Detection by immunoperoxidase staining for lactoferrin and cytochemical electron microscopy.

Neutrophils from a boy suffering from recurrent infections were found to be totally deficient in specific granules when studied by electron microscopy. In contrast, myeloperoxidase-containing azurophil granules were increased in number. This deficiency of specific granules could be detected at the light-microscopic level using an immunocytochemical technique to demonstrate the absence of lactoferrin. Neutrophils also exhibited abnormal nuclear segmentation, nuclear clefts, an abnormally weak cytochemical reaction for alkaline phosphatase, and an increased number of mitochondria and ribosomes. Some granulocytic precursors were abnormal, and many of these cells were phagocytosed by macrophages in the bone marrow. Despite these multiple abnormalities and the history of severe pyogenic infection, the in vitro bactericidal capacity of the neutrophils was within normal limits, and normal degranulation of azurophil granules occurred following phagocytosis. The precise mechanism by which the deficiency of specific granules in this patient led to an enhanced in vivo susceptibility to infection therefore remains obscure. However, attention is drawn to the fact that in three previously described cases of specific granule deficiency a history of recurrent infections was present.

Bacterial Infections↗