Multicenter GeoSentinel analysis of rickettsial diseases in international travelers, 1996-2008.

We investigated epidemiologic and clinical aspects of rickettsial diseases in 280 international travelers reported to the GeoSentinel surveillance Network during 1996-2008. Of these 280 travelers, 231 (82.5%) had spotted fever (SFG) rickettsiosis, 16 (5.

Clinical management of rapidly growing mycobacterial cutaneous infections in patients after mesotherapy.

Background: Increasing numbers of patients are expressing an interest in mesotherapy as a method of reducing body fat. Cutaneous infections due to rapidly growing mycobacteria are a common complication of such procedures.

Methods: We followed up patients who had developed cutaneous infections after undergoing mesotherapy during the period October 2006-January 2007.

Imported human African trypanosomiasis in Europe, 2005-2009.

Physicians in Europe are likely to see more African trypanosomiasis cases because of the increasing popularity of travel to Africa. In this paper the literature on imported cases in Europe, since 2005 is reviewed. Because of the high mortality risk associated with acute Rhodesian trypanosomiasis, travellers should be informed about preventive measures and the early disease manifestations.

Cutaneous miliary resistant tuberculosis in a patient infected with human immunodeficiency virus: case report and literature review.

We report the case of a patient infected with human immunodeficiency virus who presented with fever and a disseminated papulous eruption, diagnosed as cutaneous miliary tuberculosis. The diagnosis was made by histological examination of a skin biopsy, which showed numerous acid-fast bacilli. A culture grown from a skin biopsy isolated a resistant Mycobacterium tuberculosis strain.

Ivermectin versus benzyl benzoate applied once or twice to treat human scabies in Dakar, Senegal: a randomized controlled trial.

Objective: To compare the effectiveness of oral ivermectin (IV) and two different modalities of topical benzyl benzoate (BB) for treating scabies in a community setting.

Methods: The trial included patients aged 5-65 years with scabies who attended the dermatology department at the Institut d'Hygiène Sociale in Dakar, Senegal. The randomized, open trial considered three treatments: a single application of 12.

Drug hypersensitivity syndrome induced by meglumine antimoniate.

We report a case of drug hypersensitivity syndrome (drug reaction with eosinophilia and systemic symptoms [DRESS]) induced by parenteral meglumine antimoniate (Glucantime) in a 40-year-old man who traveled to Bolivia and was treated for mucocutaneous leishmaniasis. Two weeks after starting therapy, the patient had fever, joint pain, a cutaneous eruption, and hypereosinophilia (1,358 cells/mm(3)). These symptoms resolved after drug withdrawal but reappeared upon reintroduction of the drug.

Outbreak of nontuberculous mycobacterial subcutaneous infections related to multiple mesotherapy injections.

We describe an outbreak of severe subcutaneous infections due to nontuberculous mycobacteria following mesotherapy. Epidemiological studies and molecular comparisons of Mycobacterium chelonae strains from different patients and the environment suggested that contamination may be associated with inappropriate cleaning of the multiple-injection device with tap water.

[Double trypanosomal chancre revealing West African trypanosomiasis in a Frenchman living in Gabon].

Background: Human African trypanosomiasis (sleeping sickness), an endemic disease, is currently reemerging in Africa with an estimated incidence of 45,000 new cases per year. It is caused by Trypanosoma brucei subspecies and transmitted by day-biting tsetse flies.

Patients And Methods: We report a case of West African trypanosomiasis due to Trypanosoma brucei gambiense involving a Frenchman living in Libreville, Gabon.

Sexually transmitted diseases diagnosed among travelers returning from the tropics.

Objectives: Data are lacking on the spectrum of sexually transmitted diseases (STDs) diagnosed in returning travelers.

Study Design: All consecutive travelers consulting our tropical unit between November 1, 2002 and October 31, 2003 were included if they presented within 1 month after their return from the tropics, with mucocutaneous signs suggesting STDs.

Results: Forty-nine patients (12 women and 37 men; median age 36.

Skin and soft tissue infections in returning travelers.

Skin and soft tissue infections (SSTI) are a leading cause of cutaneous problems in travelers. Sixty travelers who presented with an SSTI were prospectively included over a 20-month period. Bacterial analysis and research for Panton-Valentine leukocidine (PVL) were performed according to clinical and bacterial presentation.

Long-term follow-up of imported gnathostomiasis shows frequent treatment failure.

Gnathostomiasis is increasingly reported among travelers returning from endemic areas. Between 2000 and 2004, thirteen patients were diagnosed with imported gnathostomiasis and followed for at least 6 months after treatment. Nine patients presented with cutaneous signs, two with gastrointestinal signs, and two with neurological signs.

Persistent high nevirapine blood level with DRESS syndrome 12 days after interruption of antiretroviral therapy.

Nevirapine is an antiretroviral agent associated with drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. Such a case in an immunocompetent woman recently treated with nevirapine for postexposure HIV prophylaxis is reported here. Despite a period of 12 days after interruption of treatment, a high blood level of nevirapine was still observed.

Health problems in returning travelers consulting general practitioners.

Over a 2-month period, 43 of 143 participating general practitioners included 97 patients with 113 health impairments, mainly gastrointestinal problems (35%), respiratory tract infections (30%), and skin diseases (11%). Systemic febrile illness or imported tropical disease accounted for less than 4% of cases.

Anticardiolipin antibodies in HIV infection are independently associated with antibodies to the membrane proximal external region of gp41 and with cell-associated HIV DNA and immune activation.

Background: The demonstration of in vitro cardiolipin reactivity with 2 human immunodeficiency virus (HIV)-specific, broadly neutralizing antibodies (2F5 and 4E10) has prompted reevaluation of autoimmune manifestations in HIV infection.

Methods: We evaluated autoantibodies, particularly anticardiolipin (aCL), in 67 untreated, asymptomatic, HIV-infected individuals with slow progression of HIV disease and their correlation with 2F5-, 4E10-, b12-, and 2G12-like antibodies directed against epitopes involved in broad neutralization, as well as their correlation with immune activation and virological and clinical indicators. Fifty individuals with chronic HIV infection and standard disease progression were control patients.

Fatal relapse of disseminated strongyloidiasis in an HIV-positive patient, despite ivermectin treatment.

There are no established guidelines for the treatment of disseminated strongyloidiasis in immunosuppressed patients, and many different treatment regimens have been used. Here, the case of a 48-year-old, HIV-positive, Congolese man, who was hospitalized for disseminated tuberculosis but developed life-threatening disseminated strongyloidiasis, is described. This patient died, with relapsing disseminated strongyloidiasis, 3 months after being treated with ivermectin.

Pyemotes ventricosus dermatitis, southeastern France.

We investigated 42 patients who had unusual pruritic dermatitis associated with a specific clinical sign (comet sign) in 23 houses in southeastern France from May through September 2007. Pyemotes ventricosus, a parasite of the furniture beetle Anobium punctatum, was the cause of this condition.

[Treatment of cutaneous infections due to Mycobacterium fortuitum: two cases].

Introduction: Cutaneous infections due to Mycobacterium fortuitum, a rapidly growing environmental mycobacteria, are often iatrogenic, resulting from surgery or injection. We report two cases following plastic surgery and describe the outcome after surgery and antibiotics.

Case Reports: Two immunocompetent women underwent abdominal plastic surgery and liposuction, which were complicated with recurrent abscesses one and 13 months later respectively.

Recent developments in dermatological syndromes in returning travelers.

Purpose Of Review: Dermatoses are one of the three most common healthcare problems in returning travelers. Knowledge of imported dermatoses among Western physicians is however limited. In order to provide more effective pretravel counseling and better posttravel diagnosis and treatment, improvement is called for.

Management of travelers with fever and exanthema, notably dengue and chikungunya infections.

Febrile exanthema frequently presents as an acute condition in travelers. Sixty-two travelers who presented with febrile exanthema were prospectively included over a 20-month period. Diagnostic tests were performed according to clinical presentation and risk exposures.

[Prevalence of skin disorders in HIV patients in Senegal and relationship to degree of immunosuppression].

Background: The aim was to evaluate the association between dermatological findings in HIV-infected patients in Senegal and degree of immunosuppression and HIV stage.

Patients And Methods: All consecutive HIV infected patients followed up at three dermatology centres in Senegal from 01 January 2004 to 01 January 2006 were evaluated retrospectively regarding dermatological findings, CD4 cell count and HIV stage.

Patients And Methods: One hundred and forty-nine patients with 331 skin diseases were evaluated.