Biomedical subjects

Yves Gillet

Publications and source records attributed to Yves Gillet.

7 recordsLinked to original sources

PubMed2005

Neonatal hemolytic uremic syndrome after mother-to-child transmission of Escherichia coli O157.

About 90% of cases of hemorrhagic uremic syndrome (HUS) occur in early childhood and most frequently are preceded by bloody diarrhea due to shiga-like toxin (SLT) producing Escherichia coli. We report a case of a newborn girl presenting with bloody diarrhea on her 7th day of life. Acute renal failure, severe arterial hypertension and hemolytic anemia were detected and prompt peritoneal dialysis and antihypertensive therapy were required. The girl had several episodes of seizures, necessitating intravenous phenobarbital. Transfontanel ultrasonography 48 h after disease onset was normal, whereas, MRI investigation 10 days later revealed severe ischemic lesions with beginning cystic encephalopathy. Renal function recovered and only very moderate tubular dysfunction remained. Serum analysis of factor H, von Willebrand factor protease, homocystinemia, proteins C and S, and antithrombin III were all normal. Mutation analysis of factor V Leiden, factor II, and methyltetrahydrofolate-reductase were normal. E. coli 0157:H7 and SLT 2 were detected in the stool. SLT 2 was also found in the mother's stool. This is the first report of mother-to-child transmission of SLT-producing E. coli.

Escherichia coli Infections↗

PubMed2005

Human parainfluenza virus type 4 infections: a report of 20 cases from 1998 to 2002.

BACKGROUND: Human Parainfluenza Viruses (HPIV) type 4 are responsible for respiratory infections. Unlike HPIV types 1-3, they are associated with mild infections and appear to be infrequent. Thus, they often go undetected. STUDY DESIGN: From 1998 to 2002, in 20 respiratory samples of hospitalised patient, we isolated viruses presenting a large syncytial cytopathic effect when inoculated on LLC-MK2 cells. Most of the patients (16/20) were young infants and all of them presented with respiratory infections. RESULTS: We detected 18 cases during autumn and winter, 1 case during spring and 1 during summer. We could not identify these viruses using the panel of routine assays. Samples were then analysed by specific HPIV 4 RT-PCR and IF assays. All the samples were scored positive with both methods. CONCLUSION: We conclude that HPIV 4 infections are probably underestimated. Their role in viral respiratory infections should be carefully investigated using techniques adapted to their detection and culture.

Adult↗

PubMed2004

[New Staphylococcus aureus strains].

Staphylococcus aureus strains are present in the nose of 30% of healthy humans and are responsible for skin and soft tissue infections. Deep seated infections secondarily occurred such as osteomyelitis or infective endocarditis. New toxin-associated clinical entities have been recognized such as the toxin shock syndrome, the staphylococcal scarlet fever, the staphylococcal scalded skin syndrome or the necrotising pneumonia. This later syndrome is associated with Panton Valentine leukocidin producing strains. It occurs mainly in children and has a lethality of 75%. New antibiotic resistances are also emerging, for vancomycin in hospital-acquired infections and for methicillin in community-acquired infections.

Dermatitis, Exfoliative↗

PubMed2003

Influenza burden in children newborn to eleven months of age in a pediatric emergency department during the peak of an influenza epidemic.

BACKGROUND: The aim of this study was to determine the burden of influenza-related diseases in children 0 to 11 months of age during the peak of the 2001 to 2002 influenza epidemic. METHODS: This was a prospective study at the Pediatric Emergency Department of Edouard Herriot tertiary teaching hospital in Lyon, France. The study included 304 infants 0 to 11 months of age. Consecutive patients were systematically enrolled during the 4 weeks of the influenza epidemic peak (Weeks 3 to 6, 2002). Influenza viruses were detected by antigen detection and virus culture from nasal swabs. Structured telephone interviews were conducted on Days 8 and 15 after virus detection. There was also a 6-month survey into the medicoadministrative database to detect late complications that required delayed hospitalization of influenza-positive children. RESULTS: Influenza virus was detected in 99 (33%) of 304 patients (A/H3N2 in 30% and B in 3%). Nonrespiratory symptoms were the dominant clinical manifestations in 30% of influenza-positive children. One child with influenza presented with febrile seizures. Twenty (20%) children with influenza were hospitalized. Parents reported recovery from the illness in 63 and 94% of children on Days 8 and 15, respectively. The median length of an influenza episode was 8 days. CONCLUSIONS: Our results confirm the high prevalence of influenza-related morbidity in infants during the epidemic peak. One child in three consulting to the pediatric emergency room had a virologically confirmed influenza infection regardless of the body temperature. Every fifth child with influenza was admitted to hospital, which corresponds to an admission rate of 237 per 100 000 children 0 to 11 months of age.

Age Factors↗

PubMed2003

Clinical B12 deficiency in one case of recurrent spontaneous pregnancy loss.

Moderate hyperhomocysteinaemia (HHcy) and the homozygous mutation C677T in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene are associated with increased risk of recurrent pregnancy loss. This HHcy is currently reported as a consequence of folate rather than of vitamin B12-deficient status. We describe one case of recurrent early pregnancy loss with HHcy caused by B12 deficiency. A 38-year old woman had four episodes of early spontaneous pregnancy loss. Biological data: no haemostasis disorders, HHcy (25.9 micromol/l), normal folate (5 ng/ml), B12 deficiency (< 150 pg/ml) and the MTHFR C677T homozygote genotype. A bone marrow biopsy gave evidence of moderate megaloblastosis. Parenteral B12 therapy led to normal homocysteine level within 2 months and to a successful pregnancy. In conclusion, vitamin B12 deficiency is one of the causes of recurrent pregnancy loss associated with HHcy, and serum B12 should be measured systematically in this circumstance.

Abortion, Habitual↗

PubMed2002

Community-acquired methicillin-resistant Staphylococcus aureus infections in France: emergence of a single clone that produces Panton-Valentine leukocidin.

To characterize the clinical and bacteriologic characteristics of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections, we reviewed 14 cases that were diagnosed in previously healthy patients during an 18-month period in France. Eleven patients had skin or soft-tissue infections. Two patients died of CA-MRSA necrotizing pneumonia. A case of pleurisy occurred in a child who acquired CA-MRSA from his mother, who had a breast abscess. The Panton-Valentine leukocidin genes and the lukE-lukD leukocidin genes were detected in all 14 isolates. The clonal origin of all of the isolates was demonstrated on the basis of their pulsotypes and antibiotic resistance profiles. All isolates had an agr3 allele. The combination of the Panton-Valentine leukocidin determinant (which encodes a virulence factor for primary skin infection and pneumonia) with the mecA gene (which confers antibiotic resistance and epidemicity) appears to have created a superadapted S. aureus strain that is spreading in the community.

Adolescent↗

PubMed2002

Association between Staphylococcus aureus strains carrying gene for Panton-Valentine leukocidin and highly lethal necrotising pneumonia in young immunocompetent patients.

BACKGROUND: Between 1986 and 1998, eight cases of community-acquired pneumonia due to Staphylococcus aureus strains carrying the gene for the Panton-Valentine leukocidin (PVL) were recorded in France, six of which were fatal. We aimed to assess the clinical features of these eight cases, and those of other cases identified prospectively, and to compare them with the characteristics of patients with pneumonia caused by PVL-negative strains. METHODS: We compared eight retrospective and eight prospective cases of PVL-positive S aureus pneumonia with 36 cases of PVL-negative S aureus pneumonia. For all patients, we recorded age, length of hospital stay, risk factors for infection, signs and symptoms, laboratory findings, antibiotic treatment, and serial radiological findings. FINDINGS: Median age was 14.8 years (IQR 5.4-24.0) for the PVL-positive patients and 70.1 years (59.2-81.4) for the others (p=0.001). Influenza-like illness had occurred during the 2 days before admission in 12 of the 16 PVL-positive patients, but in only three of 33 PVL-negative patients (p<0.001). PVL-positive infections were more often marked by: temperature greater than 39 degrees C (p=0.01), heart rate above 140 beats per min (p=0.02), haemoptysis (p=0.005), onset of pleural effusion during hospital stay (p=0.004), and leucopenia (p=0.001). The survival rate 48 h after admission was 63% for the PVL-positive patients and 94% for PVL-negative individuals (p=0.007). Histopathological examination of lungs at necropsy from three cases of necrotising pneumonia associated with PVL-positive S aureus showed extensive necrotic ulcerations of the tracheal and bronchial mucosa and massive haemorrhagic necrosis of interalveolar septa. INTERPRETATION: PVL-producing S aureus strains cause rapidly progressive, haemorrhagic, necrotising pneumonia, mainly in otherwise healthy children and young adults. The pneumonia is often preceded by influenza-like symptoms and has a high lethality rate.

Adolescent↗