Biomedical subjects

Jean-Pierre Romaszko

Publications and source records attributed to Jean-Pierre Romaszko.

4 recordsLinked to original sources

PubMed2006

Lemierre's syndrome and genetic polymorphisms: a case report.

BACKGROUND: Lemierre's syndrome presents a classic clinical picture, the pathophysiology of which remains obscure. Attempts have been made to trace genetic predispositions that modify the host detection of pathogen or the resultant systemic reaction. CASE PRESENTATION: A 17-year old female, with no previous medical history, was admitted to the intensive care unit for septic shock, acute respiratory distress syndrome and Lemierre's syndrome. Her DNA was assayed for single nucleotide polymorphisms previously incriminated in the detection of the pathogen, the inflammatory response and the coagulation cascade. We observed functional variations in her Toll like 5 receptor (TLR 5) gene and two coagulation variations (Tissue Factor (TF) 603 and Plasminogen-Activator-Inhibitor-1 (PAI-1) 4G-4G homozygosity) associated with thrombotic events. CONCLUSION: The innate immune response and the prothrombogenic mutations could explain, at least in part, the symptoms of Lemierre's syndrome. Genomic study of several patients with Lemierre's syndrome may reveal its pathophysiology.

Adolescent↗

PubMed2005

[Propionibacterium acnes adenitis].

INTRODUCTION: Propionibacterium acnes is a gram-positive pleomorphic rod-shaped anaerobic saprophyte of the skin, mouth and upper respiratory tract. Although associated with acne vulgaris, it is otherwise reported as a human pathogen only rarely, in various infections, notably cutaneous and osteoarticular, and in endocarditis. We report here a case of bilateral P. acnes-abscessed adenitis of the inguinal folds. CASE: A 32 year-old man presented with inguinal lymph nodes that had progressively and bilaterally reddened and become painful, with fistulation of the skin and pus. Culture of a surgical sample identified P. acnes. DISCUSSION: Although this strain has been associated with lymph node granuloma, especially in sarcoidosis, abscessed lymph node infection as seen in our patient has never been reported.

Adult↗

PubMed2005

Pseudotumor presentation of intracerebral tuberculomas.

Diagnosis of tuberculoma is difficult because of its tumorlike aspects. This report describes the case of a male who displayed a hemiplegia revealing an intracranial mass. Neuroimaging was consistent with a glioblastoma; however, the definite diagnosis was a tuberculoma. Clinical features of tuberculomas are nonspecific. Even though the neuroimaging features are sensitive, they are much less specific, with variability related to the tuberculoma course. Investigations leading to the diagnosis are histologic analysis showing a granuloma with or without caseating necrosis, and the microbiologic identification of Mycobacterium tuberculosis. Every intracranial tumor with malignant radiologic and clinical appearance must evoke a suspicion for tuberculoma.

Brain Neoplasms↗

PubMedDate not supplied

[Vancomycin-resistant Enterococcus in an epidemic situation: screening at admission for patients at risk of carriage].

OBJECTIVES: To evaluate a strategy based on screening and isolation at admission to a department of infectious diseases during an epidemic of vancomycin-resistant Enterococcus (VRE) at the University Hospital of Clermont-Ferrand. METHODS: Systematic screening for VRE by anal swabs began on November 15, 2004. Patients were isolated on admission if (a) they had been hospitalized more than 24 h in an at-risk department of our hospital or (b) they had received a course of wide-spectrum antimicrobial therapy for longer than 48 h in the three months preceding admission. Patients hospitalized in our department were screened weekly if they were treated with wide-spectrum antibiotics, had a urinary catheter left in place for one week, or were neutropenic. RESULTS: Through May 15, 2005, 12 (3.5%) of 341 swabs were found to be positive for VRE: eight were detected on admission and four during hospitalization. In all, 81 patients were isolated on admission. A case-control study confirmed that the criteria for patient isolation were indeed risk factors for VRE. Isolation was well accepted when it was clearly explained. No new case has been detected since March 2005. CONCLUSION: An isolation strategy based on known risk factors for VRE with systematic screening on admission appears to be an effective way to control an outbreak of VRE, perhaps in part because it helps to keep the medical staff alert to this problem. Isolation is well tolerated as long as it is explained clearly.

Aged↗