Lyme disease presenting as isolated acute urinary retention caused by transverse myelitis: an electrophysiological and urodynamical study.

Several neurological manifestations of Lyme disease, both central and peripheral, have been described. Reported here is a case of acute transverse myelitis related to a Lyme neuroborreliosis that presented with isolated acute urinary retention and no lower-extremity impairment. This case, documented by urodynamic and electrophysiological investigations, partially resolved after 6 weeks of intravenous ceftriaxone, affording the removal of the indwelling catheter. Alpha blocker therapy was needed for 3 months, until the complete normalisation of urodynamic and electrophysiological records. This case study indicates that whenever urinary retention is encountered associated with acute transverse myelitis or alone, the patient should be investigated for Lyme disease.

[Eosinophilia in Europeans returning from tropical countries (apropos of 36 cases)]. / Etude des hyperéosinophilies sanguines chez l'Européen au retour des pays tropicaux (à propos de 36 cas).

The etiological investigation of hypereosinophilia in 36 Europeans having returned from tropical zones permitted, by direct and indirect paraclinical tests, the diagnosis of helminthiasis in 26 cases (72.2%). The parasites in cause were bilharziosis, filariosis, strongyloidiasis, ankylostomiasis and liver flukes. Certain subjects were polyparasited. The investigation remained negative for 6 patients (16.6%), even though a parasitism was strongly suspected in at least 5 cases. In the other cases (11.1%) the etiological investigation remained doubtful with the exception of a case of non parasitic eosinophilia (polymyositis). There still remains much progress to make in rendering the actual serological tests more specific, more constant and presenting less cross reactions.

[Anti-malaria chemical prophylaxis in Europeans and anti-Plasmodium fluorescence antibodies]. / Chimioprophylaxie antipaludique de l'européen et anticorps fluorescents anti-Plasmodium.

The authors recorded clinical histories and tested serum for the presence of malaria fluorescent antibodies in 160 healthy Europeans who had been living for more than 4 weeks in West or Central Africa. Malaria or fever of unknown origin occurred in 37 of 50 subjects who were careless about taking prophylactic drugs while abroad. Out of 110 people regularly taking suppressive amino-4-quinoline therapy, 21 had presented febrile attacks but serological tests were only positive in 8 cases. Positive serological reactions at low titers were obtained in 3 subjects with no history of past infection and who had faithfully taken suppressive medications. These results confirm the value of the malaria immunofluorescence test for the detection of occult malaria in blood donors outside endemic areas, and explain the necessity to consider previous regular, irregular or absent chemoprophylaxis before interpreting the serological results of a febrile patient returning from overseas.