Asunto(s)
Úlcera del Pie/etiología , Abuso de Marihuana/complicaciones , Adulto , Humanos , Masculino , Dedos del PieRESUMEN
OBJECTIVES: Mycobacterium marinum is responsible for "fish tank granuloma", a chronic and sometimes disabling skin infection, which in France would be the most frequent "atypical" cutaneous mycobacteriosis. Tropical fish salesmen are concerned about this disease because they might sell contaminated fish and be infected themselves. A review of the literature indicated that one quarter of the patients were aquarium workers. This original study tested the salesmen's knowledge and behaviour regarding "fish tank granuloma". METHOD: This national study consisted in an anonymous questionnaire with 24 questions. RESULTS: Among forty salesmen, six of them (15 p. 100) knew this human disease well. Thirty (75 p. 100) ignored it. Among the few salesmen (22.5 p. 100) who had studied to become aquarium workers, only one third were taught about Mycobacterium marinum. Eight salesmen (20 p. 100) were concerned about the human disease: three of them were personally infected and five others had known infected colleagues or purchasers. Most of the aquarium workers immersed their hands without gloves in the fish tanks every day. Only a few destroyed all the fishes from a contaminated tank. CONCLUSIONS: Most of the tropical fish salesmen ignored "fish tank granuloma" although 20 p. 100 of them were concerned. This chronic disease, sometimes disabling, should be better known by aquarium salesmen. The national tropical fish salesmen were informed of the results of this study.
Asunto(s)
Dermatitis Profesional/prevención & control , Enfermedades de los Peces/prevención & control , Explotaciones Pesqueras , Manipulación de Alimentos , Microbiología de Alimentos , Conocimientos, Actitudes y Práctica en Salud , Infecciones por Mycobacterium no Tuberculosas/veterinaria , Mycobacterium marinum , Animales , Dermatitis Profesional/diagnóstico , Enfermedades de los Peces/diagnóstico , Peces/microbiología , Francia , Encuestas Epidemiológicas , Humanos , Infecciones por Mycobacterium no Tuberculosas/diagnóstico , Infecciones por Mycobacterium no Tuberculosas/prevención & controlRESUMEN
BACKGROUND: Subsequent to detection of several cases of anthropophilic tinea capitis, we wanted to know whether the legal decree requiring eviction from school and an epidemiology survey in the children community or the family is implemented properly. METHODS: Two sample surveys were carried out among 50 school doctors from the Hauts-de-Seine department and 110 dermatologists working the Paris suburbs. RESULTS: Eviction from school was rare and not based on the type of dermatophytes (anthropophilic or zoophilic agent). Likewise, epidemiology survey was neglected, often being solely clinical for other family members. Systematic sampling in the children community or in the family was very exceptional. DISCUSSION: Despite the rise in the number of cases of anthropophilic tinea capitis in Paris suburbs, the decree is not often implemented. Dermatologists would appear to be responsible for this situation, especially in case of M. langeronii, which is very contagious in nursery school.
Asunto(s)
Trazado de Contacto/legislación & jurisprudencia , Notificación de Enfermedades/legislación & jurisprudencia , Tamizaje Masivo/legislación & jurisprudencia , Servicios de Salud Escolar/legislación & jurisprudencia , Tiña del Cuero Cabelludo/epidemiología , Población Urbana , Niño , Femenino , Humanos , Masculino , Paris , Garantía de la Calidad de Atención de Salud/legislación & jurisprudencia , Factores de Riesgo , Tiña del Cuero Cabelludo/prevención & control , Tiña del Cuero Cabelludo/transmisiónRESUMEN
BACKGROUND: Mycobacterium malmoense is a mycobacterium rarely described as a human pathogen. We report the first case of cutaneous infection in an immunocompetent patient. CASE REPORT: A 75-year-old woman presented with a cutaneous nodula on the back of her left hand. Histology of the node biopsy showed non caseating granuloma with giant and epithelioid cells. Acid-fast bacilli were isolated at direct smear and after culture. Mycobacterium malmoense was identified. The lesion has healed after surgery. DISCUSSION: Mycobacterium malmoense is an environmental mycobacterium isolated from soil and water. Typically, most patients with Mycobacterium malmoense infections are old people with previously lung disease. A few cervical lymphadenitis in children and rare cases of tenosynovitis of the hand have been reported. Disseminated infections with cutaneous lesions have been exceptionally described in immunocompromised patients. Mycobacterium malmoense is slow growing and its identification is hard, sometimes requiring molecular analysis. Probably it's the reason why we present the first description of a cutaneous infection in an immunocompetent patient. This case indicates that Mycobacterium malmoense is also a cutaneous pathogen.
Asunto(s)
Granuloma/microbiología , Dermatosis de la Mano/microbiología , Inmunocompetencia , Infecciones por Mycobacterium no Tuberculosas/microbiología , Enfermedades Cutáneas Bacterianas/microbiología , Factores de Edad , Anciano , Técnicas de Tipificación Bacteriana , Biopsia , Femenino , Granuloma/inmunología , Granuloma/cirugía , Dermatosis de la Mano/inmunología , Dermatosis de la Mano/cirugía , Humanos , Inmunocompetencia/inmunología , Infecciones por Mycobacterium no Tuberculosas/inmunología , Infecciones por Mycobacterium no Tuberculosas/cirugía , Micobacterias no Tuberculosas/clasificación , Enfermedades Cutáneas Bacterianas/inmunología , Enfermedades Cutáneas Bacterianas/cirugía , Microbiología del Suelo , Microbiología del AguaRESUMEN
A woman presented with a chronic radiodermatitis after a percutaneous transluminal coronary angioplasty (PTCA) for unstable angina. Two PTCAs had already been performed previously. Although rare, these chronic radiodermatitis have been described after multiple cardiac catheterization procedures as a result of cumulative X-ray exposure. Prevention must therefore be implemented.
Asunto(s)
Angioplastia Coronaria con Balón/efectos adversos , Radiodermatitis/etiología , Anciano , Angina Inestable/terapia , Enfermedad Crónica , Femenino , Humanos , RetratamientoRESUMEN
A 36-year-old man with treated hairy cell leukemia developed a skin infection due to Mycobacterium marinum. A spectrum of atypical cutaneous mycobacteriosis presentations with immunosuppression can be found. The recognition of the disease needs cutaneous biopsies for histopathology and its identification by specific laboratory methods to adapt treatment.
Asunto(s)
Leucemia de Células Pilosas/complicaciones , Infecciones por Mycobacterium no Tuberculosas/patología , Mycobacterium marinum , Enfermedades Cutáneas Bacterianas/patología , Adulto , Biopsia , Claritromicina/uso terapéutico , Quimioterapia Combinada/uso terapéutico , Granuloma/microbiología , Granuloma/patología , Humanos , Masculino , Infecciones por Mycobacterium no Tuberculosas/complicaciones , Infecciones por Mycobacterium no Tuberculosas/tratamiento farmacológico , Rifampin/uso terapéutico , Enfermedades Cutáneas Bacterianas/complicaciones , Enfermedades Cutáneas Bacterianas/tratamiento farmacológicoRESUMEN
INTRODUCTION: Empty sella syndrome is sometimes associated with anterior pituitary insufficiency, the latter being mostly partial or dissociated. EXEGESIS: We report a case of a profound panhypopituitarism revealing an empty sella syndrome. This case shows that empty sella syndrome, although a generally benign and asymptomatic condition, can be associated with hypopituitarism. CONCLUSION: In case of empty sella syndrome, especially if an endocrine dysfunction is clinically suspected, minimal hormonal analysis must be requested.
Asunto(s)
Síndrome de Silla Turca Vacía/complicaciones , Hipopituitarismo/etiología , Hormona Adrenocorticotrópica/deficiencia , Síndrome de Silla Turca Vacía/diagnóstico , Femenino , Humanos , Hidrocortisona/deficiencia , Hidrocortisona/uso terapéutico , Hipopituitarismo/tratamiento farmacológico , Imagen por Resonancia Magnética , Persona de Mediana Edad , Tirotropina/deficiencia , Tiroxina/uso terapéuticoRESUMEN
BACKGROUND: We describe a case of cat-scratch disease ingnaugurated by vascular purpura and discuss the role of the causal agent, Bartonella henselae. CASE REPORT: A 49-year-old woman presented vascular purpura without fever. Skin biopsy demonstrated leukocytoclasic vasculitis. She owned a cat and a had a scratch scar on the back of her left hand. A few days later, two inflammatory epitrochlear lymph nodes suppurated. Catscratch disease was confirmed by serology and PRC analysis of pus aspirated from the nodes. The purpura resolved spontaneously in three weeks. Left axillary adenopathy developed and suppurated. In spite of four antibiotics, the nodes subsided only ten months later, leaving scars. DISCUSSION: Two arguments favor Bartonella henselae as the causal agent in this cutaneous vasculitis. The simultaneous onset of the two diseases and the absence of another cause of vasculitis. This patient did not have Bartonella henselae endocarditis which could have explained this vasculitis. Only one case of hypersensitivity vasculitis has been described during cat-scratch disease. The exceptional feature of this association is perhaps the result of the unawareness of moderate or asymptomatic cat-scratch disease. Bartonella henselae was possibility caused hypersensitivity vasculitis.
Asunto(s)
Bartonella henselae , Enfermedad por Rasguño de Gato/diagnóstico , Púrpura/diagnóstico , Enfermedades Cutáneas Vasculares/diagnóstico , Vasculitis Leucocitoclástica Cutánea/diagnóstico , Diagnóstico Diferencial , Femenino , Humanos , Enfermedades Linfáticas/microbiología , Persona de Mediana EdadRESUMEN
A patient with a commun variable immunodeficiency (CVID) is hospitalized for chronic symptoms of malabsorption (weigh loss and diarrhea). The duodenal histology show a total villous atrophy. Investigations are negative and a gluten free diet is given. Symptoms of malabsorption disappear and improvement is histologically confirmed. Our observation suggest that the coincidence of gluten sensitive enteropathy and CVID is possible and clinicians should be aware of this association and should consider giving a gluten free diet. The sensitivity of serologic testing in this conditions is unknown.
Asunto(s)
Agammaglobulinemia/complicaciones , Enfermedad Celíaca/complicaciones , Agammaglobulinemia/terapia , Atrofia , Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/dietoterapia , Humanos , Mucosa Intestinal/patología , Masculino , Persona de Mediana EdadRESUMEN
To assess immune responses to malaria-induced thrombocytopenia, an haematologic and immunologic study was performed on 25 patients with imported malaria upon admission and 8 days after treatment. Thrombocytopenia (150 x 10(9)/litre) was detected in 19 cases (P. falciparum: 11 cases, P. ovale: 6 cases, P. vivax: 2 cases). No laboratory evidence of disseminated intravascular coagulation impairment was found in any of the patients. Bone marrow examination performed in 9 cases showed no abnormality in the megakaryocyte series. Platelet count was independent of circulating parasite levels (r = 0.27) and inversely related to the number of antibody binding sites (ABS) on platelets (r = -0.6, p. less than 0.01). The indirect Coombs test (r = -0.54; p less than 0.01) and IgG and IgE levels (p less than 0.02) gave similar findings. A statistical correlation was observed between the level of circulating immune complex and the number of ABS (r = 0.525, p less than 0.01). Thus malaria-induced thrombocytopenia seems to mainly involve IgG type antiplatelet antibody activity. Although they may be implicated in the binding of antibodies to platelets, circulating immune complexes do not appear to mediate thrombocytopenia.