Primary cutaneous nocardiosis caused by Nocardia otitidiscaviarum: two cases and a review of the literature.

We report two cases of primary cutaneous nocardiosis due to Nocardia otitidiscaviarum. The first case is a mycetoma, the second, a cutaneous abcess: these two cases were imported into France (Vietnam, Zimbabwe). The literature on primary cutaneous nocardiosis due to N. otitidiscaviarum is reviewed.

[Clinical and bacteriological aspects of nocardiasis. 9 cases]. / Aspects cliniques et bactériologiques des nocardiosis. 9 observations.

OBJECTIVES: Nocardial infection is usually localized in the immunocompetent patient and occurs as an opportunistic disseminated infection in about half of the cases in immunoincompetents patients. METHODS: We report a retrospective assessment of 9 cases of nocardial infection diagnosed between January 1991 and February 1994. RESULTS: Six of the patients were immunodepressed: 3 had a disseminated infection with pulmonary (n = 2), brain (n = 2), skin (n = 3) and/or ocular (n = 1) localizations. There were 3 immunocompetent patients with an isolated local infection: skin and bone mycetoma, knee joint and lung. Diagnosis was made on samples obtained invasively in 7 patients. Nocardia asteroides was isolated in 5 patients, N. farcinica in 3 and N. caviae in 1. These organisms showed in vitro sensitivity to amoxicillin-clavulanic acid 5/9, cefotaxime 5/9 (0/3 for N. farcinica), imipeneme 7/9, amikacin 8/8, minocyclin 5/8, pefloxacin 0/8 and trimethoprime-sulfamethoxazol (TMP-SMX) 3/9. Clinical outcome was favourable in all cases and was not always correlated with laboratory sensitivity. CONCLUSION: TMP-SMX remains the reference antibiotic. For one patient, only TMP-SMX (resistant in vitro) was effective; with all the other antibiotic tried (sensitive in vivo) treatment failed.

[Cholecystitis and biliary infection]. / Cholécystitie et infection biliaire.

Cytobacteriologic study of 150 gallbladder fluid samples obtained before cholecystectomy found no correlations between clinical manifestations, gross and histologic features of the gallbladder, and underlying biliary infection. The potential parts played in these discrepancies by bile, time to surgery, and use of antimicrobial agents are discussed.

Actinomycosis of the gallbladder due to Actinomyces naeslundii.

We report two cases of actinomycosis of the gallbladder due to Actinomyces naeslundii. Both patients presented with acute cholecystitis. After cholecystectomy with the removal of gallstones each patient made an uneventful recovery. The literature on cholecystitis due to Actinomyces is reviewed.

[Campylobacter pyloridis: bacteriological study and sensitivity to antibiotics]. / Campylobacter pyloridis: étude bactériologique et sensibilité aux antibiotiques.

Twelve strains of Campylobacter pyloridis isolated in the antrum and/or fundus in 8 patients were analyzed for antibiotype. The results obtained, compared with those in the literature, enabled assessment of the culture media which are the best adapted for isolation, the main criteria for identification (urease, alkaline phosphatase, nitratereductase, growth temperature), their sensitivities (beta-lactamines, tetracyclines, macrolides) or their resistance to antibiotics (colistin, vancomycin, co-trimoxazole, nalidixic acid).

[Campylobacter pylori and gastric mucosa: histological and bacteriological study and preliminary results of an epidemiological survey in the area of Nantes]. / "Campylobacter pylori" et muqueuse gastrique: étude histologique, bactériologique et résultats préliminaires d'une enquête épidémiologique dans la région nantaise.

The aims of this study were to: a) evaluate the prevalence of Campylobacter pylori (CP) in patients referred to a gastroenterology unit for upper digestive tract endoscopy, b) compare the results of histologic (Warthin-Starry method) and bacteriologic (direct and culture) examinations, c) correlate the presence and abundance of CP with the "activity" of chronic gastritis as assessed by antral and fundic specimens, and d) report the preliminary results of an epidemiological survey in the area of Nantes, France. CP was observed in 30 of the 64 patients studied (46 p. 100 of cases), and was significantly associated with chronic gastritis of either the superficial or interstitial (87 vs. 12 p. 100 of patients positive and negative, respectively for CP studies, p less than 10(-9], and preatrophic and/or atrophic types (40 vs. 12 p. 100 of patients positive and negative, respectively, for CP studies, p less than 0.01). CP was also present in 7 of 10 patients with duodenal ulcers and in 4 to 6 with gastric ulcers. Histologic and bacteriologic studies gave concordant results in 94 p. 100 of cases, and had the same sensitivity for diagnosis. Patients positive for CP studies had a statistically significant increased incidence of epigastric burns, and, at endoscopic examination, their fundic area appeared congestive more frequently. CP were dictated in both the antrum and fundus, but lesions of chronic gastritis were more prominent in the former. There was a statistically significant correlation between the degree of inflammation observed in the lamina propria and the number of CP present in the same area (antrum and fundus).(ABSTRACT TRUNCATED AT 250 WORDS)

[Susceptibility of Campylobacter pyloridis to antibiotics]. / Sensibilité de Campylobacter pyloridis vis-à-vis des antibiotiques.

In vitro antibacterial activity of 32 antimicrobials was studied on 20 strains of Campylobacter pyloridis (CP). CP is susceptible to beta lactams, cyclins, chloramphenicol, rifampicin, macrolides, aminoglycosides, sometimes to colistin, nalidixic acid, metronidazole, never to vancomycin, trimethoprim, co-trimoxazole.

[Erysipelothrix rhusiopathiae infections. General review of 31 cases of septicemia with endocarditis reported in the literature (author's transl)]. / Les infections à Erysipelothrix rhusiopathiae. Revue générale à propos de 31 cas de septicémies avec endocardite relevés dans la littérature.

Erysipelothrix rhusiopathiae is widely distributed in nature (animal, soil). It is commonly known as the causative agent of cutaneous lesions called "erysipeloid of Rosenbach". Only 31 cases of bacterial endocarditis have been reported in the literature. The etiologic diagnosis of Esysipelothrix infection was established by the presence of bacteria in blood cultures or heart-valve cultures. Immunological study is unusual owing to the rapid course of the infection. The histologic observation of heart lesions corroborates the diagnosis. The patient's receptivity depends on his occupation, general health (importance of rheumatic heart disease), sex (male), age (from 40 to 60 years old), but also on the season (from July to October) and climate (temperate). With the exception of the few cases where it is possible to recognize a portal of entry of infection or the appearance of typical cutaneous manifestations, bacterial endocarditis due to Erysipelothrix presents a clinical picture similar to that of most other bacterial endocarditis. The antibiotic treatment is an association of penicillin-streptomycin, administered in large doses over a period of at least four weeks. In spite of intensive therapy, many patients died.