Effects of artesunate, dihydroartemisinin, and an artesunate-dihydroartemisinin combination against Toxoplasma gondii.

The effect of artesunate and its metabolite dihydroartemisinin against the cerebral cysts of Toxoplasma gondii was studied. In vitro experiments were performed with the THP-1 cell line and showed an inhibition of parasite growth of approximately 70% with 0.1-0.5 microg/ml of dihydroartemisinin for 96 hr. However, with artesunate, dihydroartemisinin, or a combination (50:50) of them, the number of tachyzoites decreased approximately 40-50% and they appeared motionless. Fifty-eight to 72 hr after washing of the tachyzoites and THP-1 cells in culture, parasitized cells reappeared. In vivo, the 50:50 artesunate-dihydroartemisinin combination produced a decrease in cerebral cysts of approximately 40% after only 5 days of treatment. However, transplantations into naive mice using brains of treated mice gave positive results.

[African tick-bite rickettsiosis: the 1st case of autochthonous infection?]. / Rickettsiose à tique africaine: première contamination autochtone?

BACKGROUND: African tick-bite fever is caused by R. africae. All cases reported to date in France have occurred among patients who came from southern Africa, the endemic zone. We report the first case, to our knowledge, of a patient infected in France. CASE REPORT: A 69-year-old white man who had never left France developed fever and 3 "black spots" on the legs with lymphangitis and enlarged nodes. The clinically suspected diagnosis was confirmed by positive serology reactions to R. africae. As cross immunity with R. conorii can occur, the diagnosis was further confirmed by western blot for R. africae and by the persistence of the reaction after adsorption of the R. conorii serum. DISCUSSION: African tick-bite fever was identified as a clinical entity different from Mediterranean spotted fever by Kelly in 1992 who demonstrated the causal role of R. africae. The typical clinical presentation associates fever, several black spots, lymphangitis and multiple node enlargement. The serological diagnosis is difficult owing to cross immunity with R. conorii. Western blot and polymerase chain reaction are required for definitive diagnosis. In our case, the infection was probably due to a R. africae imported into France in the luggage of the patient's daughter who had spent 3 months in Zimbabwe.

A case of Aspergillus myocarditis associated with septic shock.

We report a case of isolated myocardial involvement due to Aspergillus sp., in a patient with multiple organ failure but no demonstrable immune deficiency apart from corticosteroid therapy given for the three weeks prior to hospitalization. This patient died of septic shock 7 days after hospitalization. Aspergillus was isolated only once from a sputum specimen obtained 24 h before death. At post-mortem examination there are emboli and myocardial lesions containing clusters of hyphae as Aspergillus confirmed by indirect immunofluorescence. The other organs were free of fungi. This observation is remarkable because the cardiac involvement was isolated and no immunodeficiency was present.

Effects of 2',3'-dideoxyinosine on Toxoplasma gondii cysts in mice.

The activity against Toxoplasma gondii of 2',3' dideoxyinosine (ddI), an anti-human immunodeficiency virus drug, was examined in an in vitro and in vivo study. Cell cultures infected with a strain known to cause chronic infections were used to show the dose-dependent effect of this drug compared with spiramycin and sulfadiazine. When a dose of 4 microg/ml was used, no infected THP-1 cells or parasites were found after 60 h of incubation. An electron-microscopic study confirmed that after 12 h at 1 microg/ml, the few parasites observed were severely altered. The treatment of chronically infected mice 3 months postinfection showed that a 30-day treatment with 2 mg of ddI/ml induced a significant reduction in the number of T. gondii cysts in the cerebral tissue. These cysts were not viable, as confirmed by immunofluorescence and reinfection experiments. These experiments suggest a possible role for ddI in the treatment of toxoplasmosis, and this possibility deserves further investigation.

[Chlamydia trachomatis in a urogenital practice: 435 specimens collected at a Senegalese hospital]. / Chlamydia trachomatis et sphère uro-génitale: a propos de 435 prélèvement effectués en milieu hospitalier sénégalais.

Between March 1993 and April 1994, tests to detect Chlamydia trachomatis were performed by direct immunofluorescence on genital discharges from 99 men and 336 women at the Medical Biology Laboratory of Principal Hospital in Dakar, Senegal. Chlamadyial infection was demonstrated in 30 men (30.3%) and 31 women (9.2%). Working women who tested positive for Chlamydia trachomatis were significantly older than those who tested negative (p < 0.05). The opposite was true for working men (p < 0.05). The incidence of positive findings was significantly higher in students (20.5%) than in non-students (10.7%) (p < 0.05). From a clinical standpoint urethral discharge was noted in only 24% of infected men whereas vaginal discharge was present in 96% of infected women. For most infected women the motive for consultation was infertility. The findings of this study attest to the prevalence of Chlamydial infection in the population studied and underline the need for further study to determine its role in the etiology of infertility.

[Syringocystadenoma papilliferum. A case located on the knee]. / Le syringocystadénome papillifère. Un cas localisé sur le genou.

Syringocystadenoma papilliferum is an infrequent hamartoma of the sweat glands, usually of the scalp or temporal area. We observed a syringocystadenoma papilliferum in a young patient from Senegal. The lesion was unique and presented as a round 4 cm plaque with a red smooth surface. The diagnosis was based on the histologic examination. Complete surgical exeresis was performed. Localization on the knee is very unusual.

Evolution des resistances aux antibiotiques: comparaison des principaux germes isoles de pus en 1989 et 1992 a l'Hopital Principal de Dakar

Le controle de l'apparition et de l'extension des resistances des germes aux antibiotiques est un imperatif pour les laboratoires de bacteriologie hospitaliers. Afin d'etablir les bases de donnees utiles et d'initier une surveillance; le Laboratoire de Biologie de l'Hopital Principal de Dakar a compare les niveaux de resistance des principaux germes isoles de pus d'hospitalises en 1989 et 1992. Les auteurs montrent un accroissement des resistances aux molecules utilisees depuis longtemps et expriment leurs craintes vis-a-vis de l'utilisation inadequate d'antibiotiques recemment introduits

[Broad spectrum beta-lactamases: results in Principal Hospital of Dakar (February 1st 1992 - February 1st 1993)]. / Béta-lactamases à spectre élargi: bilan sur un an à l'Hôpital Principal de Dakar (1er Février 1992 - 1er Février 1993).

The intensive, unreasonable use of antibiotics makes resistant strains growing particularly in hospital areas where the selection pressure is important. During the last years, the outstanding event was the emergence of resistant strains against 3rd generation of cephalosporin. In many cases this resistance is linked with Extended broad spectrum Beta-lactamase. After the description of a simple method to detect these particular strains, the authors report the epidemiologic situation in Hopital Principal of Dakar from February 1992 to January 1993. The emergence of these resistant strains creates heavy problems in intensive care services and Pediatrics. As conclusion, principal measures to prevent this phenomen are exposed.

[Human trypanosomiasis focus of Vavoua (Ivory Coast). A clinical, parasitological and sero-immunological survey (author's transl)]. / Le foyer de trypanosomiase humaine de Vavoua (République de Côte d'Ivoire). Enquête clinique, parasitologique et séro-immunologique.

Vavoua human trypanosomiasis focus, located 60 km north of Daloa (Ivory Coast Republic) is facing a period of hyperactivity. A medical survey has been conducted in 9 villages of this focus: 7.424 persons have been examined and 128 new cases diagnosed in the field after clinical and parasitological examinations. Indirect Fluorescence Antibody Test applied to dried blood blots, in the laboratory, revealed 266 immunological suspects to be reexamined. 185 suspects were reexamined, 104 of whom were diagnosed after tyrpanosomes had been found in blood or/and in gland juice. The microhaematocrit centrifuge technique gave good results. Most of the 232 new cases were in the classical first period (unaltered CSF). Authors are insisting on the importance of survey prospections allowing an early diagnosis of sleeping sickness and on the interest of an immunodiagnostic test in addition to classical techniques to diagnose asymptomatical forms.