[Post-exposure antirabies vaccination. Early serological response to vaccine cultivated on VERO cells using a reduced 2-1-1 schedule]. / Vaccination antirabique après exposition. Réponse sérologique précoce au vaccin cultivé sur cellules VERO utilisé en schéma réduit 2-1-1.

OBJECTIVES: An abbreviated 2-1-1 schedule for post-exposure rabies vaccination would theoretically lead to more rapid production of specific antibodies than the classical schedule. We measured early serological response to the 2-1-1 schedule. METHODS: Patients consulting the antirabies centre of the Epinal hospital from June 1992 to June 1993 who had never been vaccinated and whose exposure history justified antirabies vaccination were included in this study. Fifty subjects were vaccinated with PVRV (purified vero rabies vaccine, Pasteur Institute) cultured on VERO (vervet monkey origin) cells using the abbreviated 2-1-1 schedule of 2 doses (0.5 ml = 2.5 IU/dose) on day 0 and 1 dose on days 7 and 21. Antirabies antibodies were assayed using the Platelia Rage immunoenzyme method (Diagnostic Pasteur) on day 21. Titres above 0.5 IU were considered to give protection and non-protected subjects were seen again on day 28 for a supplementary dose. RESULTS: Only 34 subjects (68%) had protective antibody titres on day 21, but by day 28, 48 (96%) had acquired immunity. In this study population, the age range was from 1 to 83 years and age over 30 years appeared to delay antibody formation. CONCLUSION: These findings emphasize the importance of initial antirabies immunoglobulins if short incubation in suspected and the need for serological follow-up if delayed antibody formation is suspected (subjects over 30).

[Parenchymatous abscess in Streptococcus anginosus (Streptococcus milleri) septicemia. Value of their systematic search, apropos of 4 cases]. / Abcès parenchymateux lors des septicémies à Streptococcus anginosus (Streptococcus milleri). Intérêt de leur recherche systématique, à propos de quatre cas.

Streptococcus anginosus, the term suggested to cover a set of streptococci previously known under various names (milleri, MG, anginosus, intermedius, constellatus), is characterized by a propensity to create parenchymatous abscesses, essentially cerebral or hepatic, particularly within the terms of septicemia. These abscesses are sometimes difficult to detect due to a difficult or non-existent symptomatology. The authors report on four cases illustrating the necessity to search for them systematically by cerebral CT scan and abdominal echography or CT scan in all cases of septicemia caused by Streptococcus anginosus.

[Polyneuropathies and myelopathy associated with a circulating anticoagulant. Apropos of 4 cases]. / Polyneuropathies et myélopathie associées à un anticoagulant circulant. A propos de quatre cas.

During one year from July 1992 to July 1993, we performed usual hemostasis tests in a population or 3,700 patients. We found 12 patients with a lupus like anticoagulant (incidence: 1/1,000). Among these 12, four had unexplained polyneuropathy or myélopathy. Lupus like anticoagulant was either isolated (two cases), either associated with thrombosis (two cases). We report these four cases and we discuss the causal or uncasual nature of this association.

[Emphysematous cystitis. X-ray computed tomographic aspect. Apropos of a case]. / Cystite emphysémateuse. Aspect scanographique. A propos d'un cas.

Emphysematous cystitis is a rare urinary infection which is characterized by gas collection within the bladder wall, with or without gas in the lumen itself. The diagnostic is radiologic. We report a new case, discovered with C.T. and we discuss the interest of this technique.

[Primary hyperparathyroidism. Round calcification as a sign of cervico-mediastinal localization of a parathyroid adenoma]. / Hyperparathyroïdisme primitif. Calcification arrondie, signe de localisation cervico-médiastinale d'un adénome parathyroïdien

The authors report the case of a man aged 59 years, with primary hyperparathyroidism; removal of a first adenoma, did not lead to recovery. Later, an egg-shell calcification was found together with a second large cervico-mediastinal parathyroid adenoma, the removal of which caused all the symptoms to disappear. After a review of other cases in the world literature with calcification of the parathyroid glands, the authors consider, before using more complicated techniques for preoperative localisation of parathyroid adenomas, one should carry out careful radiological examination of the cervical and mediastinal region. Under these conditions, one may detect significant calcifications which have escaped routine examination and may contribute to the topographic diagnosis of the parathyroid lesion sought.