Publications by authors named "Jean David Pommier"

Background: The medico-surgical management of cardiac tumors when there is a suspicion of malignancy is complex. Moreover, in a critically ill setting, the choice of diagnostic tools seems crucial.

Case Presentation: We present the case of a sixty-four-year-old patient with no prior medical history who was admitted to the intensive care unit with obstructive shock secondary to a right heart mass and pulmonary embolism.

View Article and Find Full Text PDF

Autosomal recessive deficiency of the IFNAR1 or IFNAR2 chain of the human type I IFN receptor abolishes cellular responses to IFN-α, -β, and -ω, underlies severe viral diseases, and is globally very rare, except for IFNAR1 and IFNAR2 deficiency in Western Polynesia and the Arctic, respectively. We report 11 human IFNAR1 alleles, the products of which impair but do not abolish responses to IFN-α and -ω without affecting responses to IFN-β. Ten of these alleles are rare in all populations studied, but the remaining allele (P335del) is common in Southern China (minor allele frequency ≈2%).

View Article and Find Full Text PDF

Objectives: To identify distinct phenotypes of critically ill leptospirosis patients upon ICU admission and their potential associations with outcome.

Design: Retrospective observational study including all patients with biologically confirmed leptospirosis admitted to the ICU between January 2014 and December 2022. Subgroups of patients with similar clinical profiles were identified by unsupervised clustering (factor analysis for mixed data and hierarchical clustering on principal components).

View Article and Find Full Text PDF

Liver involvement is an unusual yet frequently overlooked dengue complication. Pivotal for an efficient clinical management, the early diagnosis of dengue-associated liver involvement relies on an accurate description of its clinical and biological characteristics, its prognosis factors, its association with severe dengue and its clinical management. We conducted a systematic review by searching PubMed and Web of Science databases for original case reports, cohort and cross-sectional studies reporting the clinical and/or biological features of dengue-associated liver involvement.

View Article and Find Full Text PDF

Background: Aneurysmal subarachnoid hemorrhage (aSAH) is preferentially treated by prompt endovascular coiling, which is not available in Guadeloupe. Subsequently, patients are transferred to Paris, France mainland, by commercial airplane (6751 km flight) after being managed according to guidelines. This study describes the characteristics, management and outcomes related to these patients.

View Article and Find Full Text PDF

Background: Despite cefoxitin's in vitro resistance to hydrolysis by extended-spectrum beta-lactamases (ESBL), treatment of ESBL-producing Klebsiella pneumoniae (KP) infections with cefoxitin remains controversial. The aim of our study was to compare the clinical efficacy of cefoxitin as definitive antibiotic therapy for patients with ESBL-KP bacteremia in intensive care unit, versus carbapenem therapy.

Methods: This retrospective study included all patients with monomicrobial bacteremia hospitalized in intensive care unit between January 2013 and January 2023 at the University Hospital of Guadeloupe.

View Article and Find Full Text PDF

Purpose: To describe clinical and biological features and the outcomes of patients admitted for histoplasmosis in two intensive care units (ICU) in French Guyana and in the French West Indies (Guadeloupe).

Methods: All patients admitted to these two ICUs for culture-proven histoplasmosis between January 2014 to August 2022 were included in the study. Using univariate and multivariate analysis, we assessed risk factors at ICU admission that were associated with death.

View Article and Find Full Text PDF

Objectives: Here, we report the management of a catastrophic COVID-19 Delta variant surge, which overloaded ICU capacity, using crisis standards of care (CSC) based on a multiapproach protocol.

Design: Retrospective observational study.

Setting: University Hospital of Guadeloupe.

View Article and Find Full Text PDF
Article Synopsis
  • A study conducted between April 2018 and August 2019 collected 135 strains of extended-spectrum beta-lactamase (ESBL) producing bacteria from the University Hospital Center of Guadeloupe to analyze the diversity and structure of the bacterial population and identify the clinical relevance of certain strains.
  • Among the 94 third cephalosporin-resistant strains, 57 were identified as ESBL producers, revealing limited genetic diversity with specific sequence types (STs) being predominant, particularly ST114, ST1503, ST53, and ST113.
  • The research highlighted that Guadeloupe had a higher rate of nosocomial ESBL infections (1.59/1000 hospitalization days) compared to mainland France (
View Article and Find Full Text PDF

Background: Encephalitis is a worldwide public health issue, with a substantially high burden among children in southeast Asia. We aimed to determine the causes of encephalitis in children admitted to hospitals across the Greater Mekong region by implementing a comprehensive state-of-the-art diagnostic procedure harmonised across all centres, and identifying clinical characteristics related to patients' conditions.

Methods: In this multicentre, observational, prospective study of childhood encephalitis, four referral hospitals in Cambodia, Vietnam, Laos, and Myanmar recruited children (aged 28 days to 16 years) who presented with altered mental status lasting more than 24 h and two of the following minor criteria: fever (within the 72 h before or after presentation), one or more generalised or partial seizures (excluding febrile seizures), a new-onset focal neurological deficit, cerebrospinal fluid (CSF) white blood cell count of 5 per mL or higher, or brain imaging (CT or MRI) suggestive of lesions of encephalitis.

View Article and Find Full Text PDF

Background: The mainstay of diagnostic confirmation of acute Japanese encephalitis (JE) involves detection of anti-JE virus (JEV) immunoglobulin M (IgM) by enzyme-linked immunosorbent assay (ELISA). Limitations in the specificity of this test are increasingly apparent with the introduction of JEV vaccinations and the endemicity of other cross-reactive flaviviruses. Virus neutralization testing (VNT) is considered the gold standard, but it is challenging to implement and interpret.

View Article and Find Full Text PDF

Description of all consecutive critically ill COVID 19 patients hospitalized in ICU in University Hospital of Guadeloupe and outcome according to delay between steroid therapy initiation and mechanical ventilation onset. Very late mechanical ventilation defined as intubation after day 7 of dexamethasone therapy was associated with grim prognosis and a high mortality rate of 87%.

View Article and Find Full Text PDF
Article Synopsis
  • Japanese encephalitis virus (JEV) causes serious CNS infections in Asia, but diagnosing it is challenging due to low detection rates in serum and cerebrospinal fluid (CSF), leading researchers to explore urine as an alternative for testing.
  • This study focused on optimizing urine storage methods for JEV RNA detection using lysis buffer and a Microsep device during patient evaluations in Laos, revealing significant RNA degradation even at low storage temperatures.
  • Despite testing 41 patients, JEV RNA wasn't detected in their urine, highlighting the efficacy of lysis buffer and the necessity for larger studies to systematically test urine samples over time for better JEV diagnosis.
View Article and Find Full Text PDF
Article Synopsis
  • - The study examines the health issues faced by HIV-infected transwomen compared to HIV-infected cisgender men, focusing on metabolic syndrome, thyroid, and adrenal functions.
  • - Results showed that while the prevalence of metabolic syndrome was similar between the two groups, transwomen had significantly higher rates of subclinical hypothyroidism (12% vs. 3%) and adrenal insufficiency (20% vs. 8%).
  • - The findings indicate that although hormonal consumption was common among transwomen, it did not affect antiretroviral drug effectiveness; however, regular assessment of thyroid and adrenal functions is recommended for this population.
View Article and Find Full Text PDF
Article Synopsis
  • Japanese encephalitis virus (JEV) is the leading cause of acute encephalitis syndrome in Asia, but current diagnostic tests like JEV MAC-ELISA have low positive predictive value due to false positives from other infections.
  • A pilot study of 30 patients showed only 36.7% were JEV MAC-ELISA positive, with JEV RNA detected in throat swabs of some patients, suggesting throat swab testing could enhance diagnosis.
  • The study proposes that testing throat swabs for JEV RNA, alongside existing CSF and serum tests, could provide better insights into JEV epidemiology, as this method is non-invasive and could be applied more broadly.
View Article and Find Full Text PDF

Japanese encephalitis remains the most important cause of viral encephalitis in humans in several southeast Asian countries, including Cambodia, causing at least 65 000 cases of encephalitis per year. This vector-borne viral zoonosis - caused by Japanese encephalitis virus (JEV) - is considered to be a rural disease and is transmitted by mosquitoes, with birds and pigs being the natural reservoirs, while humans are accidental hosts. In this study we report the first two JEV isolations in Cambodia from human encephalitis cases from two studies on the aetiology of central nervous system disease, conducted at the two major paediatric hospitals in the country.

View Article and Find Full Text PDF