Rat bite fever mimicking rheumatoid arthritis.

We report a case of Streptobacillus moniliformis polyarthritis mimicking a rheumatoid arthritis, in a pet shop employee. In culture of fluid joint growth a curious Gram-negative bacillus was identified by polymerase chain reaction as Streptobacillus moniliformis. The outcome was good after surgical debridment and rifampin-clindamycin combination during 4 weeks.

Antimicrobial interventions for the management of diabetic foot infections.

Foot infections are the most common cause of hospitalisations and amputations in diabetic patients. They occur after skin ulcers or trauma in patients with peripheral neuropathy, sometimes together with vascular disease. Narrow-spectrum antibiotic agents should be prescribed for minor recent infections, and broader-spectrum agents for severe or chronic infections.

Risk factors for anaemia in patients on prolonged linezolid therapy for chronic osteomyelitis: a case-control study.

Objectives: The intrinsic properties of the new antibiotic linezolid make it an attractive candidate for the treatment of chronic osteomyelitis. However, data regarding the tolerance of long-term linezolid administration are still lacking.

Methods: The medical charts of patients given linezolid for >4 weeks were retrospectively analysed, especially their haematology.

[Nocardia otitidiscaviarum, cutaneous infection in a patient receiving long-term corticosteroid treatment].

A 62-year-old man, under long-term corticosteroid therapy for pigeon breeder's disease, was admitted to endocrinology disease department for cutaneous abscess on back, limbs and scalp. Culture of various bacteriological samples (cutaneous abscess, blood culture) isolated Nocardia otitidiscaviarum. The patient was treated by trimethoprime-sulfametoxazole during several weeks with abscess disappearance.

Pasteurella multocida aortic valve endocarditis: case report and literature review.

Pasteurella multocida is a rare cause of infective endocarditis that occurs mostly in immunocompromised patients and is therefore associated with a high mortality rate. The case is reported of a 48-year-old male patient with liver cirrhosis, who developed aortic valve endocarditis caused by P. multocida.

[Physiopathology and curative treatment of meningococcal diseases: current aspects].

Early administration of antibiotics as soon as the diagnosis of meningococcemia has been evoked is a significant therapeutic advance. However, the poor outcome of these diseases whose mortality remains high despite the current techniques of reanimation shows that improving the vaccination against meningococci is still of actuality. Diagnosing rapidly severe meningococcal disease is also a means for acting against the pathological activation of the inflammatory and coagulation pathways.

[Are the principles of treatment of chronic osteitis applicable to the diabetic foot?].

Objective: The interest of the management of bone infections in the diabetic foot, inspired by the recommendations for the treatment of chronic osteitis, was assessed in this study.

Methods: Twenty bone infections in 17 diabetic patients with moderate to mild infections of the feet were confirmed by the results of X-ray and/or scintigraphic studies and bone surgery biopsy cultures revealing one or more bacteria sensitive to standard osteitis treatment (rifampicine + fluoroquinolone). The patients had received this treatment per os for a median duration of 6 months (3 to 10 months).

Rifampicin-ofloxacin oral regimen for the treatment of mild to moderate diabetic foot osteomyelitis.

Seventeen diabetic patients with moderate to mild foot lesions associated with 20 osteomyelitic bones diagnosed by both bone scan and bone biopsy received rifampicin plus ofloxacin for a median duration of 6 months. Cure was defined as disappearance of all signs and symptoms of infection at the end of the treatment and absence of relapse during follow up. At the end of the treatment period, cure was achieved in 15 patients (88.

[Availability of antiretroviral agents in the city: a 1-year assessment in the Lille metropolitan area].

Objectives: Dispensing antiretroviral drugs in private pharmacies has been allowed in France since October 1997. One year after this measure was implemented, we conducted a survey of patients and pharmacists in the Lille metropolitan area to assess its impact.

Method: Structured interviews with a representative sample of private pharmacists and HIV infected patients in the Lille metropolitan area were carried out.

[Atypical presentation of tuberculosis in the elderly: a case report of pleuropericarditis].

Introduction: The incidence of tuberculosis is increasing, particularly in the elderly, and has various clinical presentations.

Exegesis: We describe the case of a 78-year-old woman who presented tuberculous pleuropericarditis. This case is atypical, due to infection localisation, negativity of the tuberculin skin test, and mixed pleural effusion.

Tolerance, compliance and psychological consequences of post-exposure prophylaxis in health-care workers.

Our objectives were to evaluate tolerance and compliance of post-exposure triple therapy in health-care workers (HCWs) by retrospective observational study. Structured telephone interview of HCWs identified through data from antiretroviral prescribing centres. Twenty HCWs who received triple prophylaxis were identified over one year.

[Evaluation of prescription of antibiotics in an intensive care unit].

Objectives: In order to optimize prescriptions, we conducted a qualitative evaluation of antibiotic prescription in an intensive care unit.

Methods: A prospective observational study was performed on 100 consecutive prescriptions from 11/95 to 4/96.

Results: Among 14 documented cases, initial antibiotic therapy was in accordance with antimicrobial susceptibility patterns in all but one case.

Failure of intravenous antibiotic therapy of multiple temporal brain abscesses due to Propionibacterium acnes requiring temporal lobectomy.

Propionibacterium acnes is a common skin colonizer. Its involvement in brain abscesses is generally described as a complication of neurosurgical intervention. Propionibacterium acnes is susceptible to antibiotics used as treatment of anaerobic infections, except for the 5-nitroimidazoles.