Biomedical subjects
Publications and source records attributed to M Gari-Toussaint.
This is the first published French case of a rhinosinusitis caused by Bipolaris sp. in an immunocompetent patient and suggests that this organism must be considered as an opportunistic human pathogen in warm and damp climate like the south-east of France. Bipolaris sp. is the most isolated fungi in allergic fungal sinusitis.
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Six patients were infected with Trichinella britovi in southern France following consumption of frozen wild boar meat, which had been frozen at -35 degrees C for 7 days. Microscopic examination of a sample of frozen wild boar muscle revealed the presence of rare encapsulated Trichinella larvae, identified as T. britovi. People eating wild boar must follow individual prophylactic rules such as efficient cooking of meat (at least 65 degrees C at the core for 1 minute) as recommended by the International Commission on Trichinellosis, or freezing exceeding four weeks at -20 degrees C.
INTRODUCTION: Candida arteritis can compromise the functional prognosis of the graft or even the life of the transplant recipient. The infection can be transmitted by the graft. OBSERVATION: A 46 year-old woman contracted a Candida albicans ateritis of the graft following a kidney transplant that led to a detransplantation. The yeast was probably transmitted by the graft from the donor, source of an unknown candida infection: it was found in the conservation liquid of the graft itself, and in the renal artery and vascular pedicle. Analysis of of these three elements by enzymatic electrophoresis showed that they were identical. COMMENTARIES: This case report underlines the need to establish guidelines and sanitary safety measures, notably that of systematically placing in culture the concervation solutions and alerting the transplant team if any fungi are isolated.
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INTRODUCTION: Neurocysticercosis is the most frequently encountered cerebral parasitic infection worldwide. It is due to infection of the central nervous system by Taenia solium larval form. According to the location of the cysts, parenchymal and extra-parenchymal forms may be identified, with different clinical expressions. EXEGESIS: We report two cases of neurocysticercosis, one with typical parenchymal involvement and the second with extra-parenchymal involvement revealed by increased intra-cranial pressure. In both cases, the diagnosis was established over 10 years after the onset of symptoms. CONCLUSION: Neurocysticercosis is very frequent in non-Islamic developing countries, and its incidence is increasing in industrialized nations in relation to tourism and immigration from highly endemic areas. Symptoms usually appear several years after infection and this accounts for the frequent delays before the diagnosis is established.
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We describe a case of pacemaker infection due to two fungal species: Candida albicans and C. glabrata. Transthoracic echocardiography showed a large vegetation on the intraventricular wires. Because of severe underlying diseases, surgery was believed to be contraindicated. The patient was treated using high dose of fluconazole, resulting in clinical improvement and negative blood cultures. However, 2 months later, the patient underwent a fatal stroke. At autopsy, a large vegetation was found only all along the wires. Postmortem culture of the infected material was positive for both C. albicans and C. glabrata.
Systemic tropical mycoses have been emerging since the beginning of the AIDS epidemic. The incidence of these infections is probably even underestimated since most cases occur in populations with poor access to medical care in regions where modern diagnostic methods are unavailable. In Europe, this pathology is sometimes observed in returning travelers, aid workers, and immigrants. Differential diagnosis of imported systemic tropical mycosis may be difficult for uniformed physicians. The purpose of this review of the literature is to provide up-to-date epidemiological, clinical, diagnostic, and therapeutic data on the six main systemic tropical mycoses with disseminated forms. The six mycoses described in this study are histoplasmosis, coccidioidomycosis, paracoccidioidomycosis, blastomycosis, sporotrichosis, and penicilliosis due to Penicillium marneffei. Strictly superficial and subcutaneous mycoses are not covered.
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We report a case of Aspergillus arthritis of the shoulder in a renal transplant recipient. Cultures of three joint fluid specimens grew Aspergillus fumigatus. Itraconazole as sole treatment resulted in initial clinical and roentgenographic improvements but failed to prevent deterioration in joint function. A relapse with fatal neurologic involvement occurred. Immune deficiency-inducing risk factors for aspergillosis include neutropenia and corticosteroid therapy. Previously published cases of Aspergillus arthritis of limb joints are reviewed. The advantages and limitations of itraconazole as single drug therapy are outlined.
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