We aimed to identify prognostic factors for AIDS-associated disseminated histoplasmosis. In a multivariate analysis, we found that dyspnea, a platelet count of <100,000 platelets/mm3, and lactate ...dehydrogenase levels of >2 times the upper limit of the normal range were significantly independently associated with the death of the patient during the first 30 days of antifungal treatment.
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In order to estimate the prevalence of viral excretion in cervicovaginal secretions, we made a cross-sectional study of 55 HIV-infected women. The patient population was diverse, including pregnant ...and nonpregnant women in different disease stages from three centers. Virus replication was found in the cell-free supernatant from 12 of 55 cervicovaginal samples (21.8%) by coculture on the CD4-positive cell line CEM-C113. In addition, cell-associated virus was detected in five of a subgroup of 22 samples testing negatively on cell-free supernatant. The prevalence of HIV in the cell-free supernatant was not related to disease stage, zidovudine therapy, transmission group, or history of sexually transmitted diseases. Excretion of HIV was significantly higher in our population of pregnant women (eight of 21, 38%) compared with an unmatched group of nonpregnant women (four of 34, 11.8%; p = 0.04). These results provide evidence of cell-free virus shedding as well as the presence of cell-associated virus in the genital secretions of HIV-infected women.
The production of interleukin (IL)‐13 and unresponsiveness to IL‐12 in T cells were analyzed in patients with active localized cutaneous leishmaniasis (untreated or not responsive to treatment) and ...in patients who had been treated successfully for the disease. More IL‐13 was produced by specific T cells in response to Leishmania guyanensis (L. guyanensis) antigens in active compared to in inactive leishmaniasis. Furthermore, unresponsiveness of specific T cells to IL‐12 was detected only in patients with active leishmaniasis, i.e. in patients with detectable parasites such as untreated patients and patients unresponsive to treatment. These results support that IL‐12 unresponsiveness of Leishmania‐specific T cells is responsible for the persistence of infection.
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BFBNIB, DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
La donovanose est une pathologie bactérienne, potentiellement sexuellement transmissible, à focalisation génitale prédominante. Elle réalise des ulcérations végétantes caractéristiques d’évolution ...chronique et extensive. Sa répartition géographique est particulière par l’existence de foyers endémiques bien circonscrits. En apparente involution depuis les années 1950, cette pathologie présente un regain d’intérêt de par la réapparition d’épidémies en Australie et en Afrique du Sud. Dans les années 1990, les auteurs australiens et sud-africains ont ainsi effectué des études permettant de mieux connaître la maladie et le germe responsable :
Calymmatobacterium granulomatis (
C. granulomatis). Ils ont notamment réalisé une analyse phylogénique de la bactérie et développé expérimentalement un test
polymerase chain reaction (PCR). Enfin, des auteurs australiens ont proposé des schémas thérapeutiques efficaces avec l’emploi de l’azithromycine.
Donovanosis is a bacterial pathology that may be sexually transmissible, with prevalent genital focus. It carries out characteristic chronic, extensive and vegetating ulcerations. Its geographical distribution is characterized by some endemic and well localized focuses. Apparently disappearing since the 1950s, a renewed interest is attached to this pathology since epidemics reappeared in Australia and South Africa. In the 1990s, Australian and southern African authors carried out studies allowing a better knowledge of the disease and the responsible germ: the
Calymmatobacterium granulomatis (
C. granulomatis). In particular, they carried out a phylogenic analysis of the bacterium and developed an experimental test polymerase chain reaction (PCR). Lastly, Australian authors proposed some effective therapeutic diagrams on the use of azithromycine.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
An investigation was conducted to determine whether seasonal variations affected the development of cutaneous leishmaniasis. Data from 499 cases treated between July 1994 and December 1998 were ...analyzed. The interval between infection and consultation and between treatment and clinical cure varied significantly between cases with an incubation period during the dry season compared with the rainy season (P < 0.001). When the incubation period occurred during the dry season, the standard pentamidine isethionate treatment seemed to be less effective (i.e., the odds ratio for failure was 1.9 1.1–3.4, P = 0.01). The presence of lymphangitis was more frequent during the dry season (i.e., the odds ratio was 0.26 0.15–0.45m P < 0.001). These results suggested that the observed seasonal variations were due to variations in the host/parasite balance. Converging indirect elements that suggest a role for variations in solar ultraviolet radiation are discussed.
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THE SITUATION: Buruli's ulcer is a severe necrotic cutaneous infection due to Mycobacterium ulcerans. It is a major public health problem in developing countries. FROM A CLINICAL POINT OF VIEW: The ...early stage of the infection corresponds to a painless cutaneous nodule, whereas the late stage corresponds to ulceration with detachment of the edges. There is currently no other treatment than surgical excision combined with heat therapy. FROM A DIAGNOSTIC POINT OF VIEW: Three methods can be used: direct examination of swabs stained according to Ziehl-Neelsen's method, culture in specific medium at 32 degrees C and the polymerization chain reaction assay (PCR). The latter is the technique of choice.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
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