ABSTRACT
Leprosy is a neglected endemic infectious disease in the Pacific region. In French Polynesia (FP), leprosy is no longer a public health problem at the national level, defined by the World Health Organization as a prevalence rate below 1 case per 10,000 population. However, even if its incidence has dramatically declined in FP in the last decades, leprosy is still endemic at a low level. Here we present a case of leprosy in a 34-year-old man from FP diagnosed in 2018. Clinical and microbiologic examinations, including fluorescence in-situ hybridization, led to the diagnosis of a multibacillary leprosy, and multidrug therapy was initiated. There is a need to maintain leprosy surveillance and trained medical staff for the detection and treatment of new cases.
Subject(s)
Bacterial Typing Techniques , Boutonneuse Fever/microbiology , DNA Fingerprinting , Polymorphism, Genetic , Rickettsia conorii/classification , Rickettsia conorii/genetics , Algeria , Biopsy , Cluster Analysis , DNA, Bacterial/genetics , DNA, Bacterial/isolation & purification , Genotype , Humans , Molecular Sequence Data , Phylogeny , Polymerase Chain Reaction , Rickettsia conorii/isolation & purification , Sequence Analysis, DNA , Sequence Homology , Skin/microbiologySubject(s)
Bacteria/isolation & purification , Endocarditis, Bacterial/epidemiology , Endocarditis, Bacterial/microbiology , Q Fever/epidemiology , Q Fever/microbiology , Adolescent , Aged , Antibodies, Bacterial/blood , Bacteria/genetics , Bacteria/growth & development , Bacteria/immunology , Comorbidity , DNA, Bacterial/genetics , DNA, Bacterial/isolation & purification , Female , Fluorescent Antibody Technique, Direct , France/epidemiology , Heart Valves/microbiology , Humans , Immunoglobulin G/blood , Immunoglobulin M/blood , Male , Middle Aged , Polymerase Chain Reaction , Retrospective StudiesABSTRACT
Shewanella putrefaciens is a Gram negative opportunistic pathogen which causes skin and soft tissue infections and bacteriemia in immunocompromized patients. We report a 86-year-old man, who presented with an infectious cellulitis of the leg associated with Shewanella putrefaciens bacteriemia. This patient was treated by mycophenolate mofetil for a bullous pemphigoid resistant to corticotherapy.
Subject(s)
Bacteremia/microbiology , Cellulitis/drug therapy , Cellulitis/microbiology , Gram-Negative Bacterial Infections , Shewanella putrefaciens , Aged, 80 and over , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/therapeutic use , Anti-Infective Agents/administration & dosage , Anti-Infective Agents/therapeutic use , Bacteremia/drug therapy , Ceftriaxone/administration & dosage , Ceftriaxone/therapeutic use , Ciprofloxacin/administration & dosage , Ciprofloxacin/therapeutic use , Dermatologic Agents/administration & dosage , Dermatologic Agents/therapeutic use , Drug Therapy, Combination , Follow-Up Studies , Gram-Negative Bacterial Infections/drug therapy , Humans , Immunocompromised Host , Male , Mycophenolic Acid/analogs & derivatives , Mycophenolic Acid/therapeutic use , Pemphigoid, Bullous/drug therapy , Time Factors , Treatment OutcomeABSTRACT
Bickerstaff's brainstem encephalitis (BBE) is a rare diagnosis different from meningoencephalitis with ophthalmoplegia, ataxia and confusion. Less than 100 cases have been described in the literature. We described the fatal case of a 69-year-old man who presented a severe consciousness disorders, distal weakness in the four limbs, and the BBE triad a few days after his admission for pneumonia.
Subject(s)
Brain Stem/pathology , Encephalitis/pathology , Aged , Ataxia/pathology , Consciousness Disorders/pathology , Humans , Magnetic Resonance Imaging , Male , Ophthalmoplegia/pathologyABSTRACT
Despite progress with diagnostic criteria, the type and timing of laboratory tests used to diagnose infective endocarditis (IE) have not been standardized. This is especially true with serological testing. Patients with suspected IE were evaluated by a standard diagnostic protocol. This protocol mandated an evaluation of the patients according to the modified Duke criteria and used a battery of laboratory investigations, including three sets of blood cultures and systematic serological testing for Coxiella burnetii, Bartonella spp., Aspergillus spp., Legionella pneumophila, and rheumatoid factor. In addition, cardiac valvular materials obtained at surgery were subjected to a comprehensive diagnostic evaluation, including PCR aimed at documenting the presence of fastidious organisms. The study included 1,998 suspected cases of IE seen over a 9-year period from April 1994 to December 2004 in Marseilles, France. They were evaluated prospectively. A total of 427 (21.4%) patients were diagnosed as having definite endocarditis. Possible endocarditis was diagnosed in 261 (13%) cases. The etiologic diagnosis was established in 397 (93%) cases by blood cultures, serological tests, and examination of the materials obtained from cardiac valves, respectively, in 348 (81.5%), 34 (8%), and 15 (3.5%) definite cases of IE. Concomitant infection with streptococci and C. burnetii was seen in two cases. The results of serological and rheumatoid factor evaluation reclassified 38 (8.9%) possible cases of IE as definite cases. Systematic serological testing improved the performance of the modified Duke criteria and was instrumental in establishing the etiologic diagnosis in 8% (34/427) cases of IE.
Subject(s)
Antibodies, Bacterial/blood , Bacteria/immunology , Endocarditis, Bacterial/diagnosis , Bacteria/classification , Bacteria/isolation & purification , Bacterial Infections/microbiology , Blood/microbiology , Culture Media , Endocarditis, Bacterial/classification , Endocarditis, Bacterial/microbiology , Heart Valves/microbiology , Humans , Rheumatoid Factor/blood , Serologic TestsABSTRACT
Shewanella spp. are infrequently recovered from clinical specimens. We report here on the first case of osteomyelitis due to Shewanella algae. This bacterium, at first misidentified by phenotypic tests as Shewanella putrefaciens, was subsequently identified correctly as S. algae by 16S rRNA gene sequence analysis.
Subject(s)
Gram-Negative Bacterial Infections/microbiology , Osteomyelitis/microbiology , Shewanella/classification , Shewanella/isolation & purification , Bacterial Typing Techniques , DNA, Bacterial/analysis , DNA, Ribosomal/analysis , Female , Genes, rRNA , Humans , Middle Aged , Molecular Sequence Data , Phylogeny , RNA, Ribosomal, 16S/genetics , Sequence Analysis, DNA , Shewanella/geneticsABSTRACT
Rickettsiae survival implicates adaptation to different environmental conditions. We hypothesized that multiple copies of genes in bacteria with reduced genomes might account for such a process. Transcription of spoT and sca paralogs was thus analyzed in R. conorii and R. felis.
Subject(s)
Bacterial Outer Membrane Proteins/genetics , Genes, Bacterial , Multigene Family , Rickettsia conorii/genetics , Rickettsia felis/genetics , Animals , Bacterial Outer Membrane Proteins/biosynthesis , Gene Expression Regulation, Bacterial , RNA, Bacterial/biosynthesis , RNA, Bacterial/isolation & purification , Reverse Transcriptase Polymerase Chain Reaction , Transcription, GeneticABSTRACT
PURPOSE: Tuberculosis involving the central nervous system (CNS) is rarely observed in non immuno-compromised hosts. We report herin the various clinical, biological and radiological manifestations observed in 7 patients with CNS tuberculosis. METHODS: Clinical and biological records of 7 patients with CNS tuberculosis were retrospectively studied. All patients had encephalic CT-scan and MRI in the course of the disease. RESULTS: 5 women and 2 men with a mean age of 38.4 years initially initially presented with headache (n = 6), fever (n = 5), meningeal irritation (n = 3), localizing neurological signs (n = 1). Lumbar punction revealed lymphocytic meningitis (n = 6/7). Mycobacterium tuberculosis or bovis was isolated in 3 patients only. Cerebral tomodensitography or magnetic resonance imaging were initially normal in most of cases (n = 4/7), but discovered in the course of disease basilar meningitis (n = 6), hydrocephalus (n = 6), abcess or tuberculoma (n = 4). In all the patients, initiation of the treatment was complicated by clinical and/or biological deterioration, called paradoxal reaction, leading in all cases to glucocorticoid adjunction, with various final results. Indeed, 4 patients developed neurological sequelae. No patient died. CONCLUSION: CNS tuberculosis is a rare disease in non immunocompromised patients whose diagnostic may be difficult due to the absence of specific clinical symptoms, negative initial radiological examination, as well as delayed and often negative bacterial isolation. Paradoxal reaction appeared to be frequent despite specific antibiotherapy and underlines the beneficial effects of addictive corticosteroids.