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Bonnefond S, Catroux M, Melenotte C, Karkowski L, Rolland L, Trouillier S, Raffray L. Clinical features of actinomycosis: A retrospective, multicenter study of 28 cases of miscellaneous presentations. Medicine (Baltimore) 2016; 95:e3923. [PMID: 27311002 PMCID: PMC4998488 DOI: 10.1097/md.0000000000003923] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Actinomycosis is a rare heterogeneous anaerobic infection with misleading clinical presentations that delay diagnosis. A significant number of misdiagnosed cases have been reported in specific localizations, but studies including various forms of actinomycosis have rarely been published.We performed a multicenter retrospective chart review of laboratory-confirmed actinomycosis cases from January 2000 until January 2014. We described clinical characteristics, diagnostic procedures, differential diagnosis, and management of actinomycosis of clinical significance.Twenty-eight patients were included from 6 hospitals in France. Disease was diagnosed predominately in the abdomen/pelvis (n = 9), orocervicofacial (n = 5), cardiothoracic (n = 5), skeletal (n = 3), hematogenous (n = 3), soft tissue (n = 2), and intracranially (n = 1). Four patients (14%) were immunocompromised. In most cases (92 %), the diagnosis of actinomycosis was not suspected on admission, as clinical features were not specific. Diagnosis was obtained from either microbiology (50%, n = 14) or histopathology (42%, n = 12), or from both methods (7%, n = 2). Surgical biopsy was needed for definite diagnosis in 71% of cases (n = 20). Coinfection was found in 13 patients (46%), among which 3 patients were diagnosed from histologic criteria only. Two-thirds of patients were treated with amoxicillin. Median duration of antibiotics was 120 days (interquartile range 60-180), whereas the median follow-up time was 12 months (interquartile range 5.25-18). Two patients died.This study highlights the distinct and miscellaneous patterns of actinomycosis to prompt accurate diagnosis and earlier treatments, thus improving the outcome. Surgical biopsy should be performed when possible while raising histologist's and microbiologist's awareness of possible actinomycosis to enhance the chance of diagnosis and use specific molecular methods.
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Cohen Aubart F, Haroche J, Emile J, Fuzibet J, Granel B, Grosbois B, Ly K, Lazaro E, Saadoun D, Maurier F, Raffray L, Amoura Z. Les patients ayant une maladie d’Erdheim-Chester avec mutation BRAF V600E ont un profil cardiovasculaire plus marqué que ceux non mutés. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.10.285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Raffray L, Rivière P, Bonnet H, Duffau P, Longy-Boursier M. Hépatite granulomateuse révélant une infection disséminée à Mycobacterium bovis après BCG-thérapie intravésicale. Rev Med Interne 2015; 36:626-30. [DOI: 10.1016/j.revmed.2014.10.361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 05/21/2014] [Accepted: 10/21/2014] [Indexed: 10/24/2022]
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Raffray L, Giry C, Thirapathi Y, Binois F, Moiton MP, Lagrange-Xelot M, Ferrandiz D, Jaffar-Bandjee MC, Gasque P. High leptospiremia is associated with low gamma-delta T cell counts. Microbes Infect 2015; 17:451-5. [PMID: 25899947 DOI: 10.1016/j.micinf.2015.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 04/06/2015] [Accepted: 04/10/2015] [Indexed: 01/10/2023]
Abstract
The role of innate immune cells either to mount appropriate defense mechanisms or to drive uncontrolled tissue injuries during acute leptospirosis is poorly understood. This study aimed at characterizing the selective mobilization of innate immune cells and the level of target organ injuries in response to leptospiremia. We focused on gamma-delta (γ-δ) T cells. Patients were prospectively assessed for cell count by cytometry, for bacterial load by PCR in plasma samples and for levels of soluble acute phase tissue enzymes. We found that the level of γ-δ T cells was low and inversely correlated to liver injuries and leptospiremia.
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Raffray L, Receveur MC, Beguet M, Lauroua P, Pistone T, Malvy D. Severe delayed autoimmune haemolytic anaemia following artesunate administration in severe malaria: a case report. Malar J 2014; 13:398. [PMID: 25306236 PMCID: PMC4203878 DOI: 10.1186/1475-2875-13-398] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 10/06/2014] [Indexed: 11/10/2022] Open
Abstract
Background Parenteral artesunate is recommended as first-line therapy for severe and complicated malaria. Although its efficacy has been proven, long-term safety profile is still under evaluation. Several cases of delayed haemolytic anaemia occurred after initial clinical improvement and resolution of parasitaemia in non-immune travellers and children living in endemic areas. Reports have generated concern that this phenomenon might be related to the treatment itself, either by direct toxicity or immune-related mechanism. This is a report of the first case of autoimmune haemolytic anaemia following treatment of severe malaria initially managed with parenteral artesunate with strong indication for drug-immune related mechanism. Case A 17-year old Ivoirian female travelling in France presented with fever, headache and abdominal pain seven days after her arrival. Physical examination was indicative of septic shock while blood analysis showed normal haemoglobin level, but profound thrombocytopaenia and hyperlactataemia. Blood smear analysis showed Plasmodium falciparum infection with a parasitaemia of 0.8%. Severe malaria was diagnosed according to the WHO criteria. The patient was initially managed with artemether/lumefantrine combination and then parenteral artesunate for 48 hours. Empiric antibiotic course was also initiated with ceftriaxone, metronidazole, gentamycin, and then piperacillin and ciprofloxacin. At day 14, haemoglobin dropped to 4.6 g/dL with biologic features indicative of haemolysis (LDH 658 U/L, haptoglobin <0.15 g/L). At that time, parasitaemia was negative and other infections or hereditary disorders were excluded, while Coombs’ direct antiglobulin test was positive for IgG and C3d. Antinuclear antibodies were absent. Further investigations evidenced drug-induced antibodies related to artesunate. It was concluded a drug-mediated autoimmune haemolytic anaemia. A corticosteroids regimen was initiated at 1 mg/kg/day. Outcome was favourable and corticosteroids were progressively tapered during two months. At present the patient’s condition remains stable without recurrence of haemolytic anaemia. Conclusion This is the first case of delayed haemolytic anaemia related to artesunate with a strong indication for drug-immune related mechanism. Further research is warranted to better characterize this plausible cause of post-treatment haemolysis following parenteral artesunate administration in severe malaria patients. Electronic supplementary material The online version of this article (doi:10.1186/1475-2875-13-398) contains supplementary material, which is available to authorized users.
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Raffray L, Karkowski L, Dupon M, Constans J, Pellegrin JL, Catroux M. Actinomycoses en service de médecine : série de 21 cas. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Raffray L, Assenjee L, Yvin JL, Gerber A, Bouquillard E, Renou F, Roussin C, Thirapathi-Appadu Y, Foucher A, Poubeau P, Ferrandiz D. Épidémiologie de la sclérodermie systémique à La Réunion. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bagny K, Osdoit S, Raffray L, Gerber A, Yvin J. Une poussée lupique atypique. Rev Med Interne 2014. [DOI: 10.1016/j.revmed.2014.03.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mekinian A, Braun T, Decaux O, Falgarone G, Toussirot E, Raffray L, Omouri M, Gombert B, De Wazieres B, Buchdaul AL, Ziza JM, Launay D, Denis G, Madaule S, Rose C, Grignano E, Fenaux P, Fain O. Inflammatory arthritis in patients with myelodysplastic syndromes: a multicenter retrospective study and literature review of 68 cases. Medicine (Baltimore) 2014; 93:1-10. [PMID: 24378738 PMCID: PMC4616329 DOI: 10.1097/md.0000000000000011] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
We describe the characteristics and outcome of inflammatory arthritis in patients with myelodysplastic syndrome (MDS) in a French multicenter retrospective study. Twenty-two patients with MDS (median age, 77.5 yr [interquartile range, 69-81]; 10 women) were included. Inflammatory arthritis presented as polyarthritis in 17 cases (77%) and with symmetric involvement in 15 cases (68%). At diagnosis, the median disease activity score 28 based on C-reactive protein (DAS28-CRP) was 4.5 [2-6.5]. Two patients had anti-citrullinated protein antibodies (ACPAs), and 1 had radiologic erosions. The median time between the diagnoses of arthritis and MDS was 10 months [6-42], with a median articular symptom duration of 3 months [2-8]. The diagnosis of both diseases was concomitant in 6 cases (27%); arthritis preceded MDS in 12 cases (55%), and occurred after MDS in 4 (18%). While the number of swollen and tender joints significantly decreased during follow-up, as did the median DAS28-CRP (from 4.3 [3.8-4.6] at baseline to 2.9 [1.75-3.3]; p < 0.05), CRP remained elevated (CRP >20 mg/L) in 8 patients (42%). Nevertheless, radiographic progression and new ACPA positivity were not observed during a median follow-up of 29 months [9-76]. While most of the patients were treated with steroids (n = 16) for arthritis, additional treatment was administered in only 4 patients (hydroxychloroquine, n = 2; sulfasalazine [Salazopyrin] and etanercept, n = 1, respectively). Eleven patients died during follow-up from acute myeloid leukemia (n = 5); infections (n = 3); or cerebral bleeding, cardiorespiratory failure, or undetermined cause (n = 1, respectively). Inflammatory arthritis associated with MDS can have various presentations and is often seronegative and nonerosive. Steroids alone are the most common treatment in MDS-associated arthritis, but that treatment is insufficient to control arthritis. Steroid-sparing strategies need to be identified.
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Raffray L, Malvy D. Accidental intestinal myiasis caused by Eristalis tenax in France. Travel Med Infect Dis 2014; 12:109-10. [DOI: 10.1016/j.tmaid.2013.03.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 03/07/2013] [Accepted: 03/13/2013] [Indexed: 10/27/2022]
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Bertolotti A, Raffray L, Liferman F, Doutre MS, Longy-Boursier M, Beylot-Barry M. Atteinte cutanée de la maladie d’Erdheim-Chester : 4 cas. Ann Dermatol Venereol 2013. [DOI: 10.1016/j.annder.2013.09.554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Baulier G, Victor J, Raffray L, Mercié P, Duffau P. Une toux hypogammaglobulinémique. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.10.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Raffray L, Longy-Boursier M, Bronnimann D, Duffau P, Constans J, Pellegrin JL. Actinomycoses : présentations en service de médecine interne. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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39
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Haroche J, Cohen-Aubart F, Arnaud L, Hervier B, Saadoun D, Costedoat-Chalumeau N, Besnard S, Ly KH, Pavic M, Baudet A, Raffray L, Amoura Z. Maladie d’Erdheim-Chester : étude monocentrique de 96 patients. Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Raffray L, Le Bail B, Malvy D. Hepatic visceral larva migrans presenting as a pseudotumor. Clin Gastroenterol Hepatol 2013; 11:e42. [PMID: 23395583 DOI: 10.1016/j.cgh.2013.01.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 01/28/2013] [Indexed: 02/07/2023]
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Petitpierre F, Alberti N, Raffray L, Durieux M, Veron A, Perez JT, Lasserre AS, Frulio N, Carteret T, Balageas P, Salut C, Bonnet F, Trillaud H. Acute pulmonary embolism revealing Ivemark syndrome in an adult. Diagn Interv Imaging 2013; 94:333-5. [DOI: 10.1016/j.diii.2012.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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42
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Raffray L, Dieval C, Duffau P, Mercie P, Longy-Boursier M, Malvy D. Présentation pseudotumorale d’une toxocarose hépatique. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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43
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Raffray L, Desclaux A, Duffau P, Longy-Boursier M, Dieval C, Mercié P. Fièvre récurrente : penser à la maladie de Caroli. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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44
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Vanquaethem H, Couzi L, Lazaro E, Raffray L, Dieval C, Richez C, Pham-Ledard A, Duffau P. Le rituximab dans l’indication « néphropathie lupique » : étude rétrospective du CHU de Bordeaux, France. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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45
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Martinez C, Dieval C, Raffray L, Duffau P, Mercie P, Longy-Boursier M. Erythema gyratum repens-like lors d’une poussée lupique. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bertolotti A, Gensous N, Duffau P, Mercie P, Raffray L, Longy-Boursier M. Schnitzler Syndrome : efficacité immédiate de l’anakinra. À propos d’un nouveau cas. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Raffray L, Gensous N, Duffau P, Dieval C, Mercie P, Longy-Boursier M. Vascularite digestive et maladie de Buerger. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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48
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Gensous N, Raffray L, Duffau P, Dieval C, Mercie P, Longy-Boursier M. Efficacité du traitement par infliximab dans le cadre d’une sarcoïdose hépato-pulmonaire : à propos d’un cas. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.03.208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Raffray L, Jacquemin C, Douchet I, Couzi L, Richez C, Lazaro E, Pellegrin JL, Viallard JF, Mercie P, Longy-Boursier M, Blanco P, Contin-Bordes C. Étude de l’expression d’OX40L sur les cellules dendritiques circulantes dans le lupus erythémateux systémique. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.10.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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50
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Raffray L, Dieval C, Greib C, Pellegrin JL, Viallard JF. Douleurs osseuses chroniques : un diagnostic à ne pas rater. Rev Med Interne 2011. [DOI: 10.1016/j.revmed.2011.03.311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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