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1.
Int J Infect Dis ; 69: 50-54, 2018 Apr.
Article in English | MEDLINE | ID: mdl-29408476

ABSTRACT

A case of proven Coxiella burnetii aortitis, possibly associated with giant cell arteritis (GCA), is reported. A 72-year-old man, who is a hunter, presented with weight loss, fever, jaw claudication, and hardened temporal arteries associated with a persistent inflammatory syndrome and arteritis of the whole aorta, including the brachiocephalic arteries, as seen on 18F-fluorodeoxyglucose positron emission tomography/computed tomography. The diagnosis of GCA was retained, and treatment with prednisolone was started. Given the aneurysm of the abdominal aorta, the patient underwent replacement of the abdominal aorta with an allograft. Histology showed intense chronic arteritis attributed to atherosclerosis with dissection. However, Coxiella burnetii infection was confirmed by serology and then by culture and molecular biology on the surgical specimen. A combination of hydroxychloroquine and doxycycline was added to tapered prednisolone and the outcome was favourable.


Subject(s)
Aorta, Abdominal/microbiology , Aortitis/microbiology , Coxiella burnetii/isolation & purification , Giant Cell Arteritis/diagnosis , Positron Emission Tomography Computed Tomography , Q Fever/therapy , Aged , Anti-Bacterial Agents/therapeutic use , Aorta, Abdominal/diagnostic imaging , Aortitis/therapy , Doxycycline/therapeutic use , Fluorodeoxyglucose F18 , Giant Cell Arteritis/therapy , Heart Valve Prosthesis Implantation , Humans , Hydroxychloroquine/therapeutic use , Male , Q Fever/complications , Q Fever/diagnostic imaging , Treatment Outcome
2.
Eur J Clin Microbiol Infect Dis ; 36(11): 2207-2213, 2017 Nov.
Article in English | MEDLINE | ID: mdl-28669017

ABSTRACT

Bartonella henselae, the agent of cat scratch disease (CSD), appears to be a common organism responsible for lymphadenitis in both adults and children. There is a very low isolation rate for B. henselae from lymph nodes of patients with CSD. Our objective was to evaluate B. henselae viability in a large series of lymph nodes from patients with CSD. From January to November 2016, we analyzed lymph node biopsy samples from patients diagnosed with CSD. We used reverse transcription-quantitative polymerase chain reaction (RT-qPCR) to detect B. henselae RNA, as well as cultures, histological analyses, and fluorescence in situ hybridization (FISH). We tested 87 lymph nodes positive for B. henselae DNA but only 8 (9%) presented with B. henselae RNA. We did not find a significant difference for the pap threshold cycle (CT) values between RNA-positive and RNA-negative lymph nodes (p = 0.5). Cultures, histological analyses, and FISH were negative for all the tested samples. We provide evidence that B. henselae are not or are rarely viable in most cases in the lymph nodes of patients with CSD.


Subject(s)
Bartonella henselae/isolation & purification , Cat-Scratch Disease/microbiology , Lymph Nodes/microbiology , Lymphadenitis/microbiology , Adolescent , Adult , Aged , Bartonella henselae/genetics , Bartonella henselae/growth & development , Child , Child, Preschool , Female , Humans , In Situ Hybridization, Fluorescence , Male , Middle Aged , RNA, Bacterial/genetics , Reverse Transcriptase Polymerase Chain Reaction , Young Adult
3.
New Microbes New Infect ; 8: 41-50, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26587237

ABSTRACT

Strain FF6(T) was isolated from the cervical abscess of a 4-year-old Senegalese boy, in Dakar, Senegal. MALDI-TOF MS did not provide any identification. This strain exhibited a 95.17% 16S rRNA sequence identity with Necropsobacter rosorum. Using a polyphasic study including phenotypic and genomic analyses, strain FF6(T) was an aero-anaerobic Gram-negative cocobacillus, oxidase positive, and exhibited a genome of 2,493,927 bp (1 chromosome but no plasmid) with a G+C content of 46.2% that coded 2,309 protein-coding and 53 RNA genes. On the basis of these data, we propose the creation of Necropsobacter massiliensis sp. nov.

4.
Eur J Clin Microbiol Infect Dis ; 34(3): 561-70, 2015 Mar.
Article in English | MEDLINE | ID: mdl-25348607

ABSTRACT

Molecular tools have shown an added value in the diagnosis of infectious diseases, in particular for those caused by fastidious intracellular microorganisms, or in patients receiving antibiotics before sampling. If 16S rDNA amplification had been gradually implemented in microbiology laboratories, specific real-time polymerase chain reaction (PCR) would have permitted an increase in the sensitivity of molecular methods and a reduction of contamination. Herein, we report our experience in the diagnosis of infectious diseases over two years, during which 32,948 clinical samples from 18,056 patients were received from France and abroad. Among these samples, 81,476 PCRs were performed, of which 1,192 were positive. Molecular techniques detected intracellular microorganisms in 31.3 % of respiratory samples, 27.8 % of endocarditis samples and 51.9 % of adenitis samples. Excluding intracellular bacteria, 25 % of the positive samples in this series were sterile in culture. Conventional broad-range PCR permitted the identification of fastidious and anaerobic microorganisms, but specific real-time PCR showed a significant superiority in the diagnosis of osteoarticular infections, in particular for those caused by Kingella kingae and Staphylococcus aureus, and for endocarditis diagnosis, specifically when Streptococcus gallolyticus and Staphylococcus aureus were involved. The sensitivity of conventional broad-range PCR was 62.9 % concerning overall diagnoses for which both techniques had been performed. These findings should lead microbiologists to focus on targeted specific real-time PCR regarding the clinical syndrome. Finally, syndrome-driven diagnosis, which consists of testing a panel of microorganisms commonly involved for each syndrome, permitted the establishment of 31 incidental diagnoses.


Subject(s)
Bacterial Infections/diagnosis , DNA, Ribosomal/genetics , Molecular Diagnostic Techniques/methods , Polymerase Chain Reaction/methods , RNA, Ribosomal, 16S/genetics , Bacterial Infections/microbiology , DNA, Bacterial/chemistry , DNA, Bacterial/genetics , DNA, Ribosomal/chemistry , France , Humans , Retrospective Studies , Sensitivity and Specificity
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