[Extrahepatic symptoms in the course of GBV-C/HGV infection]. / Manifestations extrahépatiques au cours de l'infection par le GBV-C/HGV.

The GBV-C/HGV virus has clearly established transmission modes, mainly blood contamination, and occasionally sexual transmission. It is frequently found among transfused patients, intravenous drug abusers, and hemodialysis patients and often associated with HCV. Its hepatic pathogenicity is very weak, marked by a moderate and transitory cytolysis. Chronic carriage is possible, but does not lead to chronic hepatitis. Carriage can be maintained before the virus disappears. The authors report the case of a patient presenting with pleuropericarditis after a blood transfusion without any other etiology than infection by GBV-C/HGV virus. The possible extrahepatic pathogenicity of the virus is suggested. This hypothesis was rarely put forward.

[In vitro evaluation of the sensitivity to fluconazole of different species of yeasts isolated in pathology]. / Evaluation de la sensibilité in vitro au fluconazole de différentes espèces de levures rencontrées en pathologie.

In a previous study, the authors developed a technique for evaluating the in vitro susceptibility (or resistance) of Candida albicans to fluconazole, using casitone broth and agar. Photometric readings of growth in liquid media proved more accurate for evaluating antifungal activity and consistently agreed with clinical findings in all studied cases. This method was consequently extended from C. albicans to other yeasts recovered from high-risk patients (C. glabrata, C. famata, C. tropicalis, C. krusei, C. pseudotropicalis, C. parapsilosis, etc...). High resolution antifungal assay medium (broth and agar) and casitone medium (broth and agar) with or without agitation (Autobac System) were used to study the activity of fluconazole against approximately one hundred yeast strains. MICs above 3.12 micrograms/ml were found for several strains, particularly belonging to the C. glabrata and C. krusei species. These values are equal to or greater than serum levels achieved during treatment with fluconazole, a fact which raises practical questions concerning fluconazole therapy and may explain the failure of fluconazole to eradicate yeasts in some patients.

[Laboratory's controls of antifungal treatment by the fluconazole of the candidiasis in immunocompromised patients]. / Apport du laboratoire dans la surveillance du traitement antifongique par le fluconazole des candidoses chez les immunodéprimés.

The use of antifungal drugs in immunocompromised patients impose to the laboratory the control of the efficacy of these therapy. With fluconazole, one of the most recent antifungal agents these control use a special method (Central Research Pfizer) different of those they are used with others antifungals. We have comparatively tested, using MIC technic four broth mediums (High Resolution medium (Oxoid) YMB (Difco) YNB dextrose (Autobac) and Casitone) and three agar mediums (HR, YMA, Casitone) incubated at 28 degrees C for 24 and 48 h. The strains of yeasts are isolated from oro-pharyngeal prelevements on HIV antibody positive patients observed during six to twelve months and eventually treated by fluconazole. Sixty patients are controlled, 33 give one or more positive cultures with 74 strains of C. albicans and four other yeasts. By determination of the MICs with seven different methods we find any resistant strains with the MICs range from 3.12 to 12.5 or 25 micrograms/ml.