Publications by authors named "Demar M"

Background: While invasive fusariosis and lomentosporiosis are known to be associated with fungemia, overall data on mold-related fungemia are limited, hampering early management. This study aimed to describe the epidemiology of mold-positive blood cultures.

Methods: Epidemiological and clinical data on mold-positive blood cultures from 2012 to 2022 were obtained from the RESSIF database.

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  • Researchers sequenced the complete genome of a rabies virus from a gold panner's cerebellum who died from unknown encephalitis in French Guiana.
  • The analysis revealed that this virus is closely related to rabies strains found in vampire bats.
  • This finding marks the second recorded case of human rabies in that region.
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  • - The report discusses a case of fatal canine visceral leishmaniasis (VL) in a 2-year-old pug from Brazil, which was imported to French Guiana, a region not typically associated with this disease.
  • - The dog initially showed a skin issue that healed, but later developed serious symptoms, leading to suspicion of VL, which was confirmed posthumously by testing for L. infantum.
  • - This case highlights the rarity of canine VL in French Guiana and suggests a need for increased local surveillance to monitor potential transmission routes of the parasite.
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French Guiana experienced an unprecedented dengue epidemic during 2023-2024. Prior to the 2023-2024 outbreak in French Guiana, DENV-3 had not circulated in an epidemic manner since 2005. We therefore studied retrospectively the strains circulating in the French Territories of the Americas (FTA)-French Guiana, Guadeloupe, and Martinique-from the 2000s to the current epidemic.

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  • Cutaneous leishmaniasis (CL) in sub-Saharan Africa is under-researched, and this study aims to review the species of Leishmania, vectors, and reservoirs contributing to human cases in the region.
  • The systematic review analyzed 188 studies and reports, revealing a rise in publications post-2010, with a notable focus on East Africa where species resistance to standard treatments poses challenges for management.
  • Emerging cases and unclear reservoir identification in regions like Sudan and Ghana highlight the need for further research on transmission dynamics and effective treatment options for CL.
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  • Human infections from Corynebacterium diphtheriae species complex (CdSC) in French Guiana increased significantly from 2016 to 2021, with 64 infections reported in 60 patients during this time period.
  • The incidence of CdSC infections rose from 0.7 cases per 100,000 in 2016 to 7.7 cases per 100,000 in 2021, with the majority of cases being cutaneous.
  • Most patients were around 30 years old, and the majority of infections were caused by C. diphtheriae, highlighting the need for greater awareness among healthcare providers for better prevention and management.
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Introduction: Sickle cell disease (SCD) is a genetic disorder with a high infectious morbidity and mortality and a heterogeneous distribution in France. One of the challenges is to differentiate a bone and joint infection (BJI) from a vaso-occlusive crisis. This challenge is particularly prevalent in French Guiana, an overseas territory with the highest incidence of SCD in France.

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(1) Background: Only a few studies on histoplasmosis in immunocompetent patients have been reported in French Guiana. Therefore, we conducted a detailed clinical description of hospitalized patients suffering with histoplasmosis among non-HIV patients. (2) Methods: This is a single-center, retrospective study conducted at Cayenne Hospital Center between 2008 and 2022.

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  • * Out of 3,443 E. coli isolates, a significant percentage (64.4%) were β-lactamase producers, with common resistance mechanisms being penicillinase production; 6.1% had extended-spectrum β-lactamase (ESBL).
  • * While susceptibility to certain antibiotics like amoxicillin/clavulanic acid declined, ciprofloxacin showed increased susceptibility; overall, resistance trends necessitate ongoing monitoring and efforts to reduce antibiotic use in the community.
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Objectives: We aimed to describe features and outcomes of cryptococcosis among HIV-seronegative individuals in a large surveillance network for cryptococcosis in France.

Methods: We included incident cases of cryptococcosis in HIV-seronegative individuals from 2005 to 2020. We compared patient characteristics, disease presentations, cryptococcal antigen results, and induction antifungal treatments according to underlying disease.

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  • - Chromoblastomycosis (CBM) is a chronic fungal disease primarily found in tropical areas, with limited data on its occurrence in French Guiana from 1950 to 2023, where a study identified 23 mostly male patients, mainly of Creole descent.
  • - The majority of cases presented lesions on the lower limbs and had a median diagnosis time of four years, with diagnostic methods including direct microscopy (78.3%) and mycological cultures (69.6%).
  • - Treatment approaches varied, involving antifungals like itraconazole and terbinafine, surgery, or a combination of these, with surgery recommended for new, localized lesions, highlighting differences in CBM compared to other mycoses
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Previous molecular studies have shown that Candida africana corresponds to the clade 13 of Candia albicans. It has been mostly involved in vulvovaginal candidiasis worldwide but few data exist in South America. The aim of our study was to investigate the prevalence of C.

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Among 1107 cryptococcosis cases from the French surveillance network (2005-2020), the proportion of HIV-seronegative individuals has recently surpassed that of HIV-seropositive individuals. We observed marked differences in patient characteristics, disease presentations, cryptococcal antigen results, infecting species, and mortality according to HIV serostatus.

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(1) Background: Until December 2021, French Guiana (FG), located in South America, faced four consecutive COVID-19 epidemic waves. This study sought to analyze the mortality trend of severe COVID-19 patients admitted to the referral ICU of FG. (2) Methods: We conducted a prospective, observational, and non-interventional study in ICU at Cayenne Hospital.

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Introduction: With over half of the population living under the poverty threshold, the social and health context in French Guiana is more difficult than in mainland France. The prevalence of diabetes is twice as great and end-stage renal failure is 45% higher than in mainland France.

Objective: Our objective was to describe the profile of diabetic patients with chronic kidney disease in French Guiana and search for possible risk factors.

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  • Lobomycosis is a rare fungal disease that has been studied in French Guiana, focusing on its histopathological features and developing a new classification system.
  • A total of 31 cases were tracked, revealing a rise in Brazilian patients since the 2000s, mainly linked to occupations in gold mining, forestry, and fishing.
  • Two forms of the disease were identified: a major form with higher fungal presence requiring aggressive treatment, and a minor form that is less severe and can often be treated surgically.
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Background: Histoplasmosis is mainly described as a disseminated disease in people living with HIV (PLHIV). Compared to historical descriptions in immunocompetent individuals, knowledge is lacking on the detailed clinical and radiological findings and outcomes of pulmonary histoplasmosis (PH). Overlooked or misdiagnosed with other AIDS-defining condition, prognostic of PLHIV may be at risk because of inappropriate care.

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Emphysematous hepatitis is a rare infectious disease, which corresponds to the presence of gas in the liver, without collection and after exclusion of vascular origin. This entity belongs to the group of emphysematous infections, whose physiopathology seems to be linked to the presence of unbalanced diabetes and to bacterial fermentation, leading to the production of gas within the liver parenchyma. Very few cases of emphysematous hepatitis have been described in the literature, and most of them had a rapidly fatal course.

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Pneumocystis jirovecii is a transmissible fungus responsible for severe pneumonia (Pneumocystis pneumonia [PCP]) in immunocompromised patients. Missense mutations due to atovaquone selective pressure have been identified on cytochrome b (CYB) gene of P. jirovecii.

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Cutaneous leishmaniasis (CL) caused by infection with the parasite exhibits a large spectrum of clinical manifestations ranging from single healing to severe chronic lesions with the manifestation of resistance or not to treatment. Depending on the specie and multiple environmental parameters, the evolution of lesions is determined by a complex interaction between parasite factors and the early immune responses triggered, including innate and adaptive mechanisms. Moreover, lesion resolution requires parasite control as well as modulation of the pathologic local inflammation responses and the initiation of wound healing responses.

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  • French Guiana is a unique region notable for its rich biodiversity and diverse communities, yet it faces paradoxes such as high poverty rates with 50% of the population living below the poverty line.
  • The territory experiences a mix of health challenges, including common infectious diseases like HIV and malaria, which require tailored medical approaches due to their unique local characteristics.
  • European resources in French Guiana facilitate advanced diagnostic and treatment options, enhancing research opportunities despite the smaller population compared to surrounding countries, and enabling better management of both common and rare diseases.
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Background: The cutaneous leishmaniasis (CL) incubation period (IP) is defined as the time between parasite inoculation by sandfly bite and the onset of the first CL lesion. IP distribution is difficult to assess for CL because the date of exposure to an infectious bite cannot be accurately determined in endemic areas. IP current estimates for CL range from 14 days to several months with a median around 30-60 days, as established by a few previous studies in both New and Old Worlds.

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