Fillaux J.,Service de Parasitologie Mycologie |
Fillaux J.,University Paul Sabatier |
Bremont F.,Service de Pneumologie Allergologie |
Cassaing S.,Service de Parasitologie Mycologie |
And 4 more authors.
Pediatric Infectious Disease Journal | Year: 2014
BACKGROUND: Aspergillus fumigatus (Af) sensitization and persistent carriage are deleterious to lung function, but no consensus has been reached defining these medical entities. This work aimed to identify possible predictive factors for patients who become sensitized to Af, compared with a control group of non-sensitized Af carriers. METHODS: Between 1995 and 2007, 117 pediatric patients were evaluated. Demographic data, CFTR gene mutations, body mass index and FEV1 were recorded. The presence of Af in sputum, the levels of Af-precipitin, total IgE (t-IgE) and specific IgE to Af (Af-IgE) were determined. Patients were divided into 2 groups: (1) "sensitization": level of Af-IgE > 0.35 IU/mL with t-IgE level < 500 IU/mL and (2) "persistent or transient carriage": Af-IgE level ≤ 0.35 IU/mL with either an Af transient or persistent positive culture. A survival analysis was performed with the appearance of Af-IgE in serum as an outcome variable. RESULTS: Severe mutation (hazard ratio = 3.2), FEV1 baseline over 70% of theoretical value (hazard ratio = 4.9), absence of Pa colonization, catalase activity and previous azithromycin administration (hazard ratio = 9.8, 4.1 and 1.9, respectively) were predictive factors for sensitization. We propose a timeline of the biological events and a tree diagram for risk calculation. CONCLUSIONS: Two profiles of cystic fibrosis patients can be envisaged: (1) patients with nonsevere mutation but low FEV1 baselines are becoming colonized with Af or (2) patients with high FEV1 baselines who present with severe mutation are more susceptible to the Af sensitization and then to the presentation of an allergic bronchopulmonary aspergillosis event. Copyright © 2013 by Lippincott Williams & Wilkins.
Phai Pang K.-A.,Hopitaux Universitaires Of Strasbourg |
Godet C.,University of Poitiers |
Fekkar A.,Service de Parasitologie Mycologie |
Scholler J.,Hopitaux Universitaires Of Strasbourg |
And 8 more authors.
Journal of Infection | Year: 2012
Objectives: To describe and estimate the rate of breakthrough invasive mould diseases (IMD) in patients receiving caspofungin. Methods: Retrospective, non-interventional study conducted in three University Hospitals. Results: Nineteen breakthrough infections have been identified including 13 aspergillosis, 2 mucormycosis, a fusariosis, a Hormographiella aspergillata infection and 2 possible IMD. Cases were equally distributed between the centres. Fourteen patients had a haematologic malignancy, four were transplant recipients (allogeneic haematopoietic stem cells in three, liver in one) and one had hepatic cirrhosis. Caspofungin has been prescribed as prophylaxis (. n = 3), empirical therapy (. n = 9) or directed therapy for candidemia (. n = 5) or aspergillosis (. n = 2). Aspergillus galactomannan was positive in serum or in bronchoalveolar lavage fluid in 10 of the 13 aspergillosis. Median duration of caspofungin treatment before breakthrough IMD was 15 days. Nine patients died within twelve weeks. Rate of breakthrough IMD in onco-haematology patients has been estimated to 7.3% for all mould infections and to 4.2% when restricted to documented aspergillosis. Conclusions: Our data call for Aspergillus galactomannan monitoring and close clinical and radiological examination in case of persistence or recurrence of infection signs in high-risk patients receiving caspofungin. © 2012 The British Infection Association.
Fillaux J.,Toulouse University Hospital Center |
Berry A.,Service de Parasitologie Mycologie
Methods in Molecular Biology | Year: 2013
Pneumocystis jirovecii is a common cause of life-threatening pneumonia among immunocompromised patients. Since P. jirovecii cannot be cultured, specific identification of it depends on examining respiratory specimens. In the last decade, PCR has been developed which allows the detection of very low levels of P. jirovecii not detectable by routine histochemical staining. We have shown that the direct immunofluorescence assay can be replaced by a real-time PCR assay given its feasibility, sensitivity, and specificity, for the detection of P. jirovecii. A negative PCR, performed on a LightCycler System ®, enables a diagnosis of Pneumocystis jirovecii pneumonia (PjP) to be excluded, and the semiquantitative result with the application of some cutoff values can have a role in distinguishing between colonized or subclinically infected patients and PjP patients. © 2013 Springer Science+Business Media, LLC.
Vanhaecke C.,Service de Maladies Infectieuses et Tropicales |
Perignon A.,Service de Maladies Infectieuses et Tropicales |
Monsel G.,Service de Maladies Infectieuses et Tropicales |
Regnier S.,Service de Maladies Infectieuses et Tropicales |
And 2 more authors.
British Journal of Dermatology | Year: 2014
Background Creeping eruption is a migratory linear cutaneous trail. In addition to hookworm-related cutaneous larva migrans (HrCLM), other diseases can also be revealed by this sign. Objectives To report the different aetiologies of creeping eruption. Methods All consecutive patients with creeping eruption presenting to our unit in Pitié Salpêtrière Hospital in Paris between 1 March 2008 and 31 January 2013 were included. The diagnoses were based on microscopic data when available (hookworm folliculitis, strongyloidiasis) or the association of epidemiological, clinical, biological features and good outcome after specific treatment (HrCLM, loiasis, gnathostomiasis). Results Seventy-four patients (95%) presented with HrCLM. All but one had been travelling in a tropical country; seven (9%) also presented with folliculitis. Skin scraping of hookworm folliculitis lesions was performed in five cases and revealed living nematode larvae in three cases. Two patients (3%) with cutaneous gnathostomiasis after returning from Bali and Japan presented with intermittent creeping dermatitis on the foot and thigh, respectively. One patient (1%), native to Cameroon, was diagnosed with loiasis and one patient (1%), with no travel history, presented with 'creeping hair'. Conclusion Hookworm-related cutaneous larva migrans explains 95% of the cases of creeping eruption; gnathostomiasis, loiasis and cutaneous pili migrans may also be diagnosed. What's already known about this topic? As hookworm-related cutaneous larva migrans (HrCLM) is the most common cause of creeping eruption, the disease HrCLM and the sign of creeping eruption have been confused for a long time. What does this study add? This is the first study to report the different aetiologies of creeping eruption and show that, besides HrCLM, several diseases can give rise to this clinical sign. © 2014 British Association of Dermatologists.
Buot G.,Service de Parasitologie Mycologie |
Toutous-Trellu L.,Hopitaux Universitaires Of Geneva |
Hennequin C.,Service de Parasitologie Mycologie
Medical Mycology | Year: 2010
While investigations on fungal contamination of swimming pools usually focus on dermatophytes, data on other potentially pathogenic molds are scarce. Here, we report the investigation of fungal colonization of the deck surrounding a hospital physical therapy swimming pool. Five series of samples from 8 sites were collected over one year from the pool surroundings. Concomitantly, 58 patients using the swimming pool were examined and samples obtained from those with suspected onychomycosis. All surface samples were positive for fungi, with Fusarium the most frequently recovered from 22 of 27 samples of sites surrounding the pool. Among the outpatients evaluated, two presented with a mixed onychomycosis from which Fusarium and Trichophyton rubrum were isolated. The questions of possible acquisition from the swimming pool area must be considered in both cases as the ungual lesions had developed within the previous three months. This warrants further studies to better understand the epidemiology of potentially pathogenic molds in areas surrounding pools in order to adopt appropriate measures to avoid contamination. This is of particular importance within medical institutions, considering the potential role of Fusarium onychomycosis as a starting point for disseminated infections in immunocompromised patients. © 2010 ISHAM.
[Incidence of malaria among United Nations troops deployed in the Ituri district of Democratic Republic of Congo (ex-Zaire) during a 12-month period spanning 2005 and 2006]. [Evaluation de l'importance du paludisme chez les militaires de l'ONU déployés sur le district de i'Ituri en ex-Zaïre pendant une période de 12 mois des années 2005-2006.]
Er-Rami M.,Service de parasitologie mycologie
Médecine tropicale : revue du Corps de santé colonial | Year: 2011
The purpose of this study was to determine the incidence of malaria in United Nations (UN) troops deployed in northeastern Democratic Republic of Congo (ex-Zaire). A one-year study was conducted from June 2005 to May 2006. The study was retrospective for the first six months and prospective for the second. During the study period, a total of 99 cases of malaria requiring hospitalization at the UN Level II Hospital in the town of Bunia, Democratic Republic of Congo were recorded among UN troops. Malaria accounted for approximately 36% of all hospitalizations for medical diseases. The offending species in 98% of cases was Plasmodium falciparum. Transmission was highest from April to September. There were no deaths. Parasitemia was less than or equal to 2% in 91% of cases.
Dechy-Cabaret O.,Service de Parasitologie Mycologie |
Dechy-Cabaret O.,National Polytechnic Institute of Toulouse |
Benoit-Vical F.,Service de Parasitologie Mycologie |
Benoit-Vical F.,National Polytechnic Institute of Toulouse |
Benoit-Vical F.,Toulouse 1 University Capitole
Journal of Medicinal Chemistry | Year: 2012
Although the illness malaria is caused by the asexual blood stages, the presence of gametocytes is directly responsible for the infection of the vector Anopheles, thus perpetuating the plasmodial cycle. Fight against malaria is more than ever a current problem, and the solution will probably go through the development of efficient molecules against gametocytes. Knowledge of the pharmacological properties of antiplasmodials is helpful in term of using relevant molecules to treat malaria and to eradicate this dramatic public health problem. The effects of the major antiplasmodial drugs including artemisinin-based combination therapies on gametocyte load are thus reviewed herein, making the difference whenever possible between the effects on gametocytogenesis and the gametocytocidal activity. Current status on the portfolio of the most promising anti-gametocytes compounds is also presented. A close analysis of the relationship between chemical structure and antiplasmodial activity should help the design of novel antimalarial drugs targeting Plasmodium sexual stages. © 2012 American Chemical Society.
De Chauvin M.F.,Service de Parasitologie mycologie
Revue Francophone des Laboratoires | Year: 2011
Prior to initiating treatment of onychomycosis, it is important that clinical diagnosis be confirmed by mycological examination. Dermatophyte onychomycosis is an infection due to a true pathogen fungus and consecutive of cutaneous dermatophytosis extension to nail. Candida onychomycosis and non dermatophyte moulds onychomycosis are opportunistic infections. The causative role of isolated Candida or moulds in culture may be discussed. Choice of topical and systemic antifungal drugs and appropriate mesures implicate the causative agent and type of onychomycosis according the recommendations for clinical pratice of the French Dermatological Society. © 2011 - Elsevier Masson SAS - Tous droits réservés.
Dei-Cas E.,Service de parasitologie mycologie
Ethique et Sante | Year: 2010
This work examined the consequences of the use of reduction as prevailing strategy of analysis in biological research. It questioned the resulting representations of living and their impact on the biological field and beyond. Such representations contribute to configure or to influence conceptions of living promoted by education, culture or mass medium. They get an ethical dimension because they could influence clinical practices, decisions of health authorities, selection of research priorities, training of young researchers, and, more generally, management of living. The booming of postgenomic methods to approach transcriptome, proteome, metabolome, etc., as well as the growing interest in systems biology are likely expressing the need of escaping from reduction limits to reach more global views of the living mechanisms. Present emphasis on emergence as an essential feature of living, as well as on nonlinearity of biological processes are apparently better adapted to complexity, historic and evolving features of living. New approaches and analytical strategies should produce representations of living and health more compatible with such conceptions and their bioethical involvements. Ethics of living interacts thus with the epistemologies of biology: it meets up with ethics of biological research and consubstantiates with it. © 2009 Elsevier Masson SAS. All rights reserved.
Develoux M.,Service de parasitologie mycologie
Journal de Mycologie Medicale | Year: 2016
Mycetoma are chronic subcutaneous infections, endemic in dry tropical regions. It can be caused either by actinomycetes or by fungi, presenting as filamentous grains in vivo. The foot is the most common localization. The main complication is osseous involvement. Patients are rural workers living in areas situated far from medical centers. Too often, they reach well-equipped hospitals with advanced mutilating lesions. Early case detection is the first condition for good therapeutic results. Clinical presentations of actinomycetoma and eumycetoma are similar, only biological diagnosis can distinguish the two etiological forms. This distinction is essential as medical therapy for each is radically different. Precise identification of the causal agent is required for targeted treatment but it can only be realized in rare specialized laboratories. For actinomycetoma, standard therapy is trimethoprim-sulphamethoxazole (STX). Duration of treatment period is one-year minimum. In case of poor response to STX or high risk of dissemination, a combination with amikacin gave high cure rate. Other options as amoxicillin-clavulanate are available. Medical cure of actinomycetoma is generally obtained with antibiotic treatments and surgical indications are exceptional. Disappointing results were observed using antifungal in the treatment of eumycetoma and medical therapy must be completed with surgical excision. Itraconazole is now the most used drug, new triazoles are on evaluation. © 2016 Elsevier Masson SAS.