Short-course treatment with ceftriaxone for leptospirosis: a retrospective study in a single center in Eastern France.

Short-course (less than 7 days) antibiotic treatments have been rarely assessed in the management of leptospirosis. We analyzed the charts of patients hospitalized with confirmed and probable leptospirosis in a teaching hospital between 1994 and 2012. Of 89 patients with confirmed or probable leptospirosis, 21 patients (11 confirmed, 10 probable - 14 uncomplicated and 7 severe forms) admitted between 2001 and 2012 received ceftriaxone (1-2 g daily) for less than 7 days.

Leptospirosis in Franche-Comté (FRANCE): clinical, biological, and therapeutic data.

Objectives And Method: We report the patient data in 77 cases of leptospirosis confirmed by PCR and/or serology (micro-agglutination), observed between 1994 and 2008 at the Besançon teaching hospital. Our aim was to compare the epidemiological, clinical, biological, and therapeutic characteristics of leptospirosis in the Franche-Comté region, to those reported in other regions.

Results: The median age was 42years and 95% were male patients.

Synthetic peptide issued from Hap1/LipL32 for new early serodiagnosis of human leptospirosis.

Leptospirosis is a worldwide zoonosis. Today, serological diagnosis is generally assessed by MAT. We performed ELISA with a synthetic peptide derived from Hap1/lipL32 which is a protein expressed only by pathogenic Leptospira.

A subset of functional effector-memory CD8+ T lymphocytes in human immunodeficiency virus-infected patients.

CD8(+) T cells provide protective immune responses via both cytolytic and non-cytolytic mechanisms in subjects infected with human immunodeficiency virus (HIV). In the present study, we investigated the CD28 expression of CD8(+) T cells present in the peripheral blood lymphocyte subset isolated from chronically HIV-infected subjects. Using flow cytometric analysis, a continuous spectrum of CD28 intensity ranging from negative to high, which could be separated into CD28-negative, intermediate (int) and high, was seen for CD8(+) T cells.

Safety and immunogenicity of subcutaneous or intramuscular administration of a monovalent inactivated vaccine against Leptospira interrogans serogroup Icterohaemorrhagiae in healthy volunteers.

The safety and immunogenicity of a monovalent inactivated vaccine against Leptospira interrogans serogroup Icterohaemorrhagiae was evaluated in 84 volunteers according to the route of administration, i.e., subcutaneous (SC) or intramuscular (IM), in a double-blind randomised trial.

[Risk factors for Abacavir-induced hypersensibility syndrome in the "real world"].

Unlabelled: Abacavir (ABC) is a generally well-tolerated NRTI. However, up to 5% of patients may develop hypersensitivity syndrome (HSS) within the first weeks of treatment. The objectives of this study were to describe the side effects of ABC, to evaluate the incidence of the ABC-HSS, and to identify the risk factors of HSS after first exposure to ABC in a cohort of patients followed up in a university HIV clinic.

CXCR4-mediated T cell apoptosis in human immunodeficiency virus infection.

Mechanisms of CXCR4-mediated T lymphocyte apoptosis in human immunodeficiency virus (HIV) infection are poorly understood. The authors used peripheral blood mononuclear cells isolated from HIV type 1-infected subjects and assessed both CD4(+) and CD8(+) T cell apoptosis in the presence and absence of CXCR4 blockade by AMD3100. Both CD4(+) and CD8(+) T cell apoptosis could be inhibited by CXCR4 blockade, mostly in acquired immunodeficiency syndrome subjects and more weakly in asymptomatic HIV-positive subjects, and depended only partially on the syncytium-inducing/non-syncytium-inducing viral envelope phenotype.

The management of leptospirosis.

How to quickly identify patients who should be treated for leptospirosis is a challenge. The interest of polymerase chain reaction (PCR) assays is currently being evaluated and rapid tests which can be used outside of the specialised laboratory, have recently been developed. Leptospires are sensitive to many antibiotics and few clinical studies have been made to compare different treatment options.

[Ecthyma gangrenosum caused by Pseudomonas stutzeri with bacteraemia and systemic vascularitis].

Introduction: Ecthyma gangrenosum is a cutaneous manifestation of Pseudomonas infections. This condition may be associated with bacteraemia but can also occur in the absence of bacteraemia.

Exegesis: The authors report the case of a 66-year-old woman presented with necrotic ulcerations on the face associated with fever, arthralgia, myalgia, fatigue and neutropenia.

Lipschütz genital ulceration: a rare manifestation of paratyphoid fever.

In 1913, a distinctive clinical entity of acute genital ulcer occurring in an adolescent girl with a non-venereal infectious aetiology was described by Lipschütz. Since the initial description, several aetiologies have been discussed, and among them, paratyphoid fever is very uncommon. After her return from a trip, a 25-year-old girl developed high fever and diarrhoea.

[Critical analysis of antibiotic treatment of acute gastroenteritis in infants and young children].

Background: Antibiotics are usually not recommended in the management of acute gastroenteritis (AGE) in infants. Our study aimed at testing whether our practice was in adequacy with this recommendation.

Methods: We reviewed the files of infants hospitalized for AGE from January 1999 to June 2000.

Low serum procalcitonin level accurately predicts the absence of bacteremia in adult patients with acute fever.

The ability of measurement of serum procalcitonin (PCT) levels to differentiate bacteremic from nonbacteremic infectious episodes in patients hospitalized for community-acquired infections was assessed. Serum samples were obtained from adult inpatients with fever to determine the serum PCT level, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR). Of 165 patients, 22 (13%) had bacteremic episodes and 143 (87%) had nonbacteremic episodes.

[Leptospiroses].

Leptospirosis is a worldwide zoonosis, that is most frequently encountered in tropical and subtropical areas. In France, during the last years, its incidence has increased. Epidemiology is conditioned by a wide animal reservoir.

Evaluation of vancomycin use in a large university-affiliated hospital in eastern France in 1999.

Objective: In 1999, we conducted a retrospective drug utilization review to determine the volume and pattern of vancomycin use in a university-affiliated hospital in eastern France.

Methods: Total vancomycin use was determined and expressed as vancomycin courses per 100 admitted patients and defined daily doses (DDD) of vancomycin per 100 patient-days. The indication for vancomycin use was classified as appropriate or inappropriate according to the guidelines issues by the HICPAC.

Antibiotic susceptibility and genotypic characterization of Haemophilus influenzae strains isolated from nasopharyngeal specimens from children in day-care centers in eastern France.

Objective: To determine the overall carriage rate for Haemophilus influenzae in young children in day-care centers, the frequency of resistance to various classes of antibiotic, and the clonal relationship between isolates of the various resistant phenotypes.

Methods: Nasopharyngeal (NP) specimens were obtained and cultured on chocolate agar with bacitracin. Antibiotic susceptibility testing and serotyping were performed for all isolates.

Validation of a diagnosis model for differentiating bacterial from viral meningitis in infants and children under 3.5 years of age.

The aim of this study was to validate, in a population of infants and children under 3.5 years of age, a diagnosis model that provides a figure for the probability of bacterial meningitis (pABM), based on four parameters collected at the time of the first lumbar tap: the cerebrospinal fluid (CSF) protein level, CSF polymorphonuclear cell count, blood glucose level, and leucocyte count. The best cut-off value for distinguishing between bacterial and viral meningitis was previously found to be 0.

[1977 mortality rate in HIV-infected patients presenting with hepatitis C cirrhosis. Results of the GERMIVC multicenter survey conducted in French departments of internal medicine or infectious disease].

Purpose: Hepatitis C (HCV) has a high prevalence (10-30%) among human immunodeficiency virus (HIV)-infected patients. However, little information is available regarding the impact of hepatitis C on survival. The objective of our study was to determine the incidence of hepatitis C-related deaths in HIV-HCV co-infected patients.

[Behcet disease with cardiac and pulmonary manifestations].

Background: Behçet's disease is a multisystem illness rarely including cardiac involvement. We report a case characterized by a mural cardiac mass in the right ventricle.

Case Report: A 14-year-old boy presented with a full set of symptoms leading to the diagnosis of Behçet's disease.

Systemic cat scratch disease: hepatic and splenic involvement about 3 pediatric cases.

Numerous diseases can lead to multinodular lesions of liver and spleen; surgical biopsy can be required for the etiologic diagnosis. Among these diseases, systemic cat scratch disease has been recently described. Macroscopical appearance of the lesions is evocative and must be known by surgeons.