Une lésion osseuse ostéolytique n’est pas toujours révélatrice d’une pathologie néoplasique.
Nous rapportons l’observation d’une femme de 82ans splénectomisée dont le bilan de douleurs sous-costales ...révélait une masse hépatique calcifiée et une lésion vertébrale ostéolytique de L5 attribuée à une localisation osseuse d’échinococcose alvéolaire. Ce diagnostic était basé sur l’aspect typique de la masse hépatique hétérogène associée à une sérologie positive pour l’échinococcose alvéolaire.
À notre connaissance, il s’agit du premier cas d’échinococcose alvéolaire chez un patient splénectomisé. Cet antécédent pourrait avoir constitué un facteur de dissémination du parasite.
Osteolytic lesions are not always related to malignancies.
We report an 82-year-old woman suffering from subcostal pain. The patient underwent a splenectomy 40 years previously. CT-scan and MRI highlighted a calcified hepatic lesion associated with an osteolytic lesion of the L5 vertebra. Osteolytic and hepatic lesions were attributed to an alveolar echinococcosis based on positive serological assays.
To our knowledge, this is the first report of an alveolar echinococcosis in a patient with splenectomy and secondary lesions. We suggest that the splenectomy could have promoted the parasite spreading to vertebra.
We describe an outbreak of varicella in 31 Sudanese refugees (all except one were male, mean age: 26 ± 1), from the Calais migrant camp and sheltered in a French transit area. The attack rate was ...39%. Adults are scantly immunized against varicella zoster virus in East Africa and may be exposed to epidemics once in France.
Bulletin Infovac-France COHEN, R; GUERIN, N; PINQUIER, D ...
Archives de pédiatrie : organe officiel de la Société française de pédiatrie,
05/2013, Letnik:
20, Številka:
5
Journal Article
L’hépatite A est une maladie humaine à transmission féco-orale, très répandue dans le monde. La France est un pays d’endémicité faible et une proportion importante de sa population n’est pas ...immunisée ; les enfants y sont particulièrement réceptifs, notamment aux virus qui circulent dans les pays de haute endémicité (importés par des voyageurs non vaccinés) ; ils contribuent à leur diffusion le plus souvent dans le milieu familial, mais le risque d’épidémie n’est pas négligeable dans les établissements et les communautés aux conditions sanitaires précaires ou chez les professionnels qui prennent en charge les enfants en bas âge, les handicapés psychomoteurs… Les vaccins contre l’hépatite A, efficaces et bien tolérés, immunisent à long terme et ont démontré leur efficacité dans la prévention de la transmission à des sujets contacts, pouvant contribuer à enrayer l’extension d’une épidémie. En France, les indications de la vaccination ont été récemment étendues. Il est fortement recommandé de vacciner les voyageurs se rendant dans des pays d’endémie, y compris les enfants à partir de l’âge d’un an. Les enfants, nés et vivant en France qui n’ont pas eu l’occasion de s’immuniser naturellement contre l’hépatite A, dont l’un des parents au moins est originaire d’une zone d’endémie, devraient être vaccinés systématiquement dans la perspective d’un probable futur séjour dans le pays de leur(s) parent(s). Les enfants atteints de mucoviscidose ou d’une pathologie susceptible d’évoluer vers une hépatopathie chronique devraient l’être également. La vaccination est également indiquée pour les professionnels s’occupant de la garde et de la prise en charge des enfants n’ayant pas atteint l’âge de la propreté (y compris les assistantes maternelles), comme le personnel des structures collectives de garde pour handicapés. Par ailleurs, la vaccination sera pratiquée aux contacts familiaux non immunisés d’une personne atteinte d’une hépatite A ou chez les enfants des communautés vivant dans des conditions sanitaires précaires.
Hepatitis A is a human worldwide disease with a fecal-oral transmission. France is a low endemicity country where a large part of the population has never been naturally immunised: Most of the children are susceptible and may be contaminated by viruses imported from countries where viruses are endemic. Children participate in the spreading of the disease not only in household contacts but also in schools and collective care facilities. Childcare workers may also be contaminated. HAV vaccines are efficient and well tolerated. They provide long duration immunity. They can even protect recently-exposed contacts and contribute in limiting the extension of an outbreak. In France, the range of vaccination indications has been recently enlarged. The need for vaccination of travellers and residents in endemic areas has been reemphasized even for children of one year old or more. Children born and living in France lacking to be immunised whose at least one of the parents is original from an endemic area should be vaccinated because they are supposed to have the opportunity to come to the country of their parent(s). Cystic fibrosis and chronic liver disease patients susceptible to have an evolution toward cirrhosis and hepatic insufficiency are indications for vaccination. Vaccination recommendations have been extended to all the childcare professionals who are in charge of children before the age of stool continence as well as those who are in charge of youth with developmental disabilities. Elsewhere, vaccination must be done for preventing the settling of infection in household close contacts or in susceptible children in communities with poor sanitary conditions.
Chaque année, la National Foundation for Infectious Diseases (NFID - Fondation américaine pour les maladies infectieuses) rassemble plus de 300 personnes pour faire le point des dernières avancées ...scientifiques dans le domaine des vaccins et identifier les nouvelles voies de recherche les plus prometteuses. Ces conférences figurent parmi les plus importantes réunions scientifiques entièrement dédiées à la recherche sur les vaccins, que ce soit dans le secteur de la santé humaine ou dans le secteur de la santé animale. Lors de la 15e conférence, qui s’est tenue à Baltimore en mai 2012, se sont succédé conférences plénières par des experts invités de renommée internationale, sessions parallèles, présentations de posters et rencontres entre experts et jeunes chercheurs. Différents thèmes ont été abordés, allant des fondements de la vaccination, de l’exploration de la réponse immunitaire et de la conception de nouveaux vaccins et adjuvants jusqu’à l’évaluation de l’impact sur le terrain des vaccins nouvellement introduits (rotavirus, HPV) et de la sécurité des vaccins, en passant par les stratégies de vaccination, notamment dans les pays en développement. Les nouvelles techniques de la vaccinologie systémique permettant l’étude de la réponse immunitaire dans son ensemble ouvrent de nouvelles pistes pour établir des corrélats de protection, et concevoir de nouveaux vaccins, notamment contre les maladies chroniques, comme le sida ou le paludisme, pour lesquelles l’immunité naturelle est imparfaite.
Every year, the National Foundation for Infectious Diseases brings together more than 300 participants to review progress in vaccine research and development and identify the most promising avenues of research. These conferences are among the most important scientific meetings entirely dedicated to vaccine research for both humans and animals, and provide a mix of plenary sessions with invited presentations by acknowledged international experts, parallel sessions, poster sessions, and informal exchanges between experts and young researchers. During the Fifteenth Conference that took place in Baltimore in May 2012, various topics were addressed, including the scientific basis for vaccinology; exploration of the immune response; novel vaccine design; new adjuvants; evaluation of the impact of newly introduced vaccines (such as rotavirus, HPV vaccines); vaccine safety; and immunization strategies. The new techniques of systems biology allow for a more comprehensive approach to the study of immune responses in order to identify correlates of protection and to design novel vaccines against chronic diseases such as AIDS or malaria, against which natural immunity is incomplete.
We describe an outbreak of varicella in 31 Sudanese refugees (all except one were male, mean age: 26 ± 1), from the Calais migrant camp and sheltered in a French transit area. The attack rate was ...39%. Adults are scantly immunized against varicella zoster virus in East Africa and may be exposed to epidemics once in France.
Surgical percutaneous bone biopsy specimen after a 14-day antibiotic-free period represents the gold standard of care for diabetic foot osteomyelitis but may be difficult to implement in many ...institutions. We evaluate a simplified strategy based on the results of per-wound bone specimen culture. For that purpose, we retrospectively reviewed the charts of 80 consecutive patients with diabetic osteomyelitis and bone sample obtained via the wound after a careful debridement. The outcome was defined as favourable if there was a complete healing of the wound with no sign of infection and stable or improved bone X-ray 6 months after antibiotic therapy completion. Culture of bone specimens was positive in 96% of patients, although half of the patients did receive a course of antimicrobials within 14 days of the bone specimen being obtained. A total of 129 bacterial isolates were obtained from bone cultures with a mean of 1.6 ± 1 isolates per patient (Staphylococcus aureus: 33%; coagulase-negative staphylococci: 14%; streptococci: 9%; enterococci: 12%; corynebacteria: 4%; Gram-negative bacilli: 20%; anaerobes: 4%). Forty-six percent of cultures were monomicrobial. The mean duration of follow-up from diagnosis was 17 ± 1 months. Six months after discontinuation of antibiotics, six patients (7.5%) had died, nine were considered as therapeutic failures and 65 were considered as cured. Fifty-four of these 65 patients had follow-up data available at 1 year and remained in remission. In conclusion, a simplified procedure based on the culture of bone sample obtained via the ulcer after a careful debridement of the wound is effective in the medical management of diabetic foot osteomyelitis.
Les infections àNocardia sont rares et surviennent plutôt chez les patients immunodéprimés, le plus souvent à partir d’un foyer infectieux pulmonaire. Nous rapportons le cas d’un homme ...immunocompétent ayant présenté un abcès du psoas et des abcès cérébraux àNocardia asteroides, sans atteinte pulmonaire, peu de temps après la mise en place d’une prothèse totale de hanche. L’hypothèse d’une origine nosocomiale est discutée.
Nocardia infections are rare and usually occurred in immunocompromised patients with systemic dissemination from a lung infection. We report a case of an immunocompetent patient in whom Nocardia asteroides had cause psoas and cerebral abcess without pulmonary infection, a short period after a hip prosthesis insertion. The clinical history is highly suggestive of a hospital-acquired infection.
In 2009–2011, 113 adult in- and outpatients with measles were referred to the University Hospital of Clermont-Ferrand (centre of France): 71 (62.8 %) needed hospitalisation, 31 had pneumonia, 29 ...diarrhoea, 47 liver enzymes elevation, 38 thrombopaenia, one encephalitis and there were no deaths. Nineteen cases occurred among healthcare workers and five of them were hospital-acquired. There were 92 unvaccinated patients. The 2011 peak of that measles re-emerging epidemic occurred when non-immunised adults were affected.
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