[Lyme disease. Clinical, biological and developmental aspects. 29 cases in the Orléans region]. / Maladie de Lyme. Aspects cliniques, biologiques et évolutifs. 29 cas en région orléanaise.

The description of Lyme's disease (LD) in 3 stages (like syphilis), has now become classical. 29 cases of LD, between June 1981 and November 1986, have been recorded at the Hospital in Orleans. The first twelve patients that were clinically diagnosed before the serology was introduced in France, have been recalled in order to search for possible late forms and assay their antibody level of anti-Borrelia burgdorferi. The preponderance of neurological forms (22 cases) and the scarcity of peripheral and/or arthralgic arthritis (8 cases) are emphasized by this study. Radiculalgias (18 cases in 22 meningo-radiculitis), especially in the lower extremities (14 cases), required hospitalization in rheumatology in 21 instances. Spinal algias (16 cases), were only isolated, at the time of hospitalization, in one case. The intense and nocturnal nature of the radiculalgias and spinal algias was noted in 17 of 18 cases, and 16 of 16 cases, respectively. Two atrio-ventricular blocks required hospitalization in cardiology. The long-term follow-up (3 to 5 years) of 12 patients revealed only 2 cases of severe asthenia and swelling at the puncture site in one case. There were no entesopathies nor chronic arthritis. The search for anti-Borrelia burgdorferi antibodies in the serum, was positive 24 times in 28. In the 4 cases where the serology was negative, the samplings were taken after a follow-up of more than three years in 3 instances.(ABSTRACT TRUNCATED AT 250 WORDS)

[Peritonitis in renal failure patients treated by continuous ambulatory peritoneal dialysis. Treatment by intraperitoneal administration of a group M penicillin]. / Les péritonites des insuffisants rénaux traités par dialyse péritonéale continue ambulatoire. Traitement par administration intrapéritonéale d'une pénicilline du groupe M.

From February 1980 to February 1983, 55 patients with chronic renal failure were put on continuous ambulatory peritoneal dialysis. Eighty-four episodes of peritonitis occurred., i.e one episode every 9.9 months of treatment. Since staphylococci accounted for 58% of the germs identified, intraperitoneal therapy with a penicillin M was instituted while dialysis was continued through chambers. Cure was obtained in 85.7% of all episodes, either with the penicillin M alone (57% of the cases) or after adjustment of the antibiotic therapy to bacteriological results (28.6% of the cases). Dialysis was discontinued in 10 patients (18%) on account of the peritonitis. The duration of hospital stay for peritonitis was 3.6 days per patient per year. These results were compared with those obtained by other groups. The advantages of penicillin M are its ease of administration, its narrow spectrum and high activity against the pathogens most commonly encountered, and its very low toxicity.

[The role of transfusions in post-operative cytomegalovirus infections (in non-immunosuppressed subjects)]. / Rôle des transfusions au cours des infections à cytomégalovirus post-chirurgicales (chez des sujets non immunodéprimés).

Cytomegalovirus (CMV) infection is most frequently observed after open heart surgery with extracorporeal circulation (ECC) and common after thoracic surgery without ECC and after splenectomies though very rare after other types of surgery. Studies on open heart patients with ECC carried out in the period 1968-1979 show an average seroconversion rate of 28% while the febrile mononucleosis syndrome rate would amount to 4.2%. Seroconversion is defined as a confirmed increase in the titer of complement fixing (CF) antibody by a factor of 4 or more. The risk of CMV infection is proportional to the quantity of blood transfused. Fresh blood was initially suspected of being the cause, but later investigator have found no difference between fresh and preserved blood. Seroconversion and/or infection risks can be sharply cut by using deleukocyted blood or frozen deglycerolized erythrocytes free of viable leukocytes. Seroconversion risk increases significantly when CMV (CF) antibodies are present in transfused blood. However, the presence of these antibodies in the recipient's blood appears to afford protection against seroconversion and/or infection, except in the case of immunodepressed patients. In conclusion, CMV febrile mononucleosis syndrome might be due to latent CMV in the transfused blood. This transfusion of allogenic blood might induce an immunological reaction that reactivates the latent CMV transmitted to recipient.

[Comparative study of two microbiological assay methods of serum isoniazid]. / Etude comparative de deux méthodes de dosage microbiologique de l'isoniazide sérique.

Two microbiological assay techniques for estimation of biologically active isoniazid concentrations in human serum were compared : the vertical diffusion method and a large plate method similar to that commonly used for the antibiotics. Four hundred seventy four tests were carried out on the serum from 133 patients. Parallel titrations were determined by two biologists on the same serum samples, with the same standard solutions, by the two methods performed rapidly after the collection of specimens and after they have been stored in the frozen state during one week and were compared. It was found that the variability obtained in these conditions was 26 per cent for the vertical diffusion method and 14 per cent for the large plate method. The correlation coefficients were 0,87 and 0,95 respectively. Also it will be noted that the large plate method is faster, of lower cost and require smaller volumes of serum. However, it also failed to detect levels lower than 0,5 and upper than 2 micrograms/ml, the standard curve is not stable and must be run with each assay and it is also subject to interference by other antibiotics.

[Spontaneous mononucleosis due to cytomegalovirus in otherwise healthy subjects. Prospective study of 28 cases (author's transl)]. / Syndromes mononucléosiques spontanés à cytomégalovirus survenant chez des individus sains. Etude prospective de 28 observations.

Fever was a constant feature in 28 subjects with spontaneous mononucleosis due to cytomegalovirus and lasted 15 days or more in almost all cases (26/28). Blood mononucleosis and biochemical hepatic disorders were virtually always present but appeared later, so that the fever was initially thought to be "isolated". Splenomegaly was found in 39.3 p. cent of the cases. Skin rashes developed in 5 patients who had received ampicillin. Non-specific immunological abnormalities were detected in 8 of the 13 patients in whom they were looked for. The diagnosis was established by serological tests, which showed either a significant rise in, or (in patients seen at a late stage of the disease) high, sustained antibodies titers. The virus was found in blood in seven patients among the fourteen in whom it was looked for. We believe that these findings in otherwise healthy subjects could be termed "primary infection". The condition invariably followed a favourable course in the absence of any treatment. Contrary to what is observed in infectious mononucleosis, there was no sore throat and the Paul-Bunnel Davidsohn test always gave negative results.

[Cytotoxic action of Pseudomonas aeruginosa hemolysin]. / Action cytotoxique de l'hémolysine de Pseudomonas aeruginosa.

The cytopathic action of haemolysin of Pseudomonas aeruginosa has been studied in mouse and human leucocytes. The morphological changes suggest that haemolysin affects the molecular architecture of the cell membrane, whose permeability is increased. It does not induce non-specific stimulation of peripheral lymphocytes. Normal sera and albumin neutralize the hemolytic activity of haemolysin; this inhibition is also observed, to a les extent, on the lytic action on leucocytes. This raises the possibility that the two activities are probably associated with the same molecule.

[Dwarf colony mutants of Escherichia coli: plasmids resistant to antibiotics]. / Mutants déficients à colonies naines d'Escherichia coli: étude des plasmides de résistance aux antibiotiques.

Deficient dwarf colony (DDC) mutants of E. coli K 12, harboring or no resistance plasmids, were obtained in vitro. The R plasmids of parental strains and to DDC mutants were transfered by conjugation to normal colony, and to DDC mutants of E. coli K 12; the frequencies of transfer were similar for all strains studied.

[Acute purulent meningitis of traumatic origin. 16 cases]. / Méningites aiguës purulentes d'origine traumatique. 16 cas

The current frequency of road accidents leads to the necessity to seek a possible head injury in the past history of patients suffereing from acute purulent meningitis. This investigation must be all the more assiduous in the presence of a meningitis which is pneumococcal in origin and recurrent. Rhinorrhoea is a sign of primary importance. Tomography of the frontal and sagittal views of the skul remains of value. Radio-isotope studies of the CSF happile make up for the deficiencies of radiological examination, without providing an infallible means for the detection of osteomeningitis defects. The authors report their findings and therapeutic results in 16 patients collected in a series of 162 cases of acute purulent meningitis.