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Luciani L, Bichon A, Mortier C, Bourenne J, Carvelli J, Gainnier M, Doudier B, Chalvignac V, Zandotti C, Nougairède A. Acute hepatitis associated with an echovirus 9 infection in a heart transplant recipient. J Med Virol 2023; 95:e28262. [PMID: 36310370 DOI: 10.1002/jmv.28262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/28/2022] [Accepted: 10/27/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Léa Luciani
- Unité des Virus Émergents (UVE), Aix-Marseille Université, Marseille, France.,Assistance Publique-Hôpitaux de Marseille (AP-HM), IHU Méditerranée infection, Service de Virologie Aigue et Tropicale, Marseille, France
| | - Amandine Bichon
- Service de Réanimation des Urgences, Assistance Publique-Hôpitaux de Marseille (AP-HM), Centre Hospitalo-Universitaire Timone, Marseille, France
| | - Coline Mortier
- Assistance Publique-Hôpitaux de Marseille (AP-HM), IHU Méditerranée Infection, Service d'infectiologie, Marseille, France
| | - Jérémy Bourenne
- Service de Réanimation des Urgences, Assistance Publique-Hôpitaux de Marseille (AP-HM), Centre Hospitalo-Universitaire Timone, Marseille, France
| | - Julien Carvelli
- Service de Réanimation des Urgences, Assistance Publique-Hôpitaux de Marseille (AP-HM), Centre Hospitalo-Universitaire Timone, Marseille, France
| | - Marc Gainnier
- Service de Réanimation des Urgences, Assistance Publique-Hôpitaux de Marseille (AP-HM), Centre Hospitalo-Universitaire Timone, Marseille, France
| | - Barbara Doudier
- Assistance Publique-Hôpitaux de Marseille (AP-HM), IHU Méditerranée Infection, Service d'infectiologie, Marseille, France
| | - Virginie Chalvignac
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Chirurgie Cardio-Thoracique, Centre Hospitalo-Universitaire Timone, Marseille, France
| | - Christine Zandotti
- Unité des Virus Émergents (UVE), Aix-Marseille Université, Marseille, France.,Assistance Publique-Hôpitaux de Marseille (AP-HM), IHU Méditerranée infection, Service de Virologie Aigue et Tropicale, Marseille, France
| | - Antoine Nougairède
- Unité des Virus Émergents (UVE), Aix-Marseille Université, Marseille, France.,Assistance Publique-Hôpitaux de Marseille (AP-HM), IHU Méditerranée infection, Service de Virologie Aigue et Tropicale, Marseille, France
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Cassir N, Cardona F, Tissot-Dupont H, Bruel C, Doudier B, Lahouel S, Bendamardji K, Boschi C, Aherfi S, Edouard S, Lagier JC, Colson P, Gautret P, Fournier PE, Parola P, Brouqui P, La-Scola B, Million M. Observational Cohort Study of Evolving Epidemiologic, Clinical, and Virologic Features of Monkeypox in Southern France. Emerg Infect Dis 2022; 28:2409-2415. [PMID: 36241422 PMCID: PMC9707593 DOI: 10.3201/eid2812.221440] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2023] Open
Abstract
We enrolled 136 patients with laboratory-confirmed monkeypox during June 4-August 31, 2022, at the University Hospital Institute Méditerranée Infection in Marseille, France. The median patient age was 36 years (interquartile range 31-42 years). Of 136 patients, 125 (92%) were men who have sex with men, 15 (11%) reported previous smallpox vaccinations, and 21 (15.5%) were HIV-positive. The most frequent lesion locations were the genitals (68 patients, 53%), perianal region (65 patients, 49%), and oral/perioral area (22 patients, 17%). Lesion locations largely corresponded with the route of contamination. Most (68%) patients had isolated anal, genital, or oral lesions when they were first seen, including 56 (61%) who had >1 positive site without a visible lesion. Concurrent sexually transmitted infections were diagnosed in 19 (15%) patients, and 7 patients (5%) were asymptomatic. We recommend vaccination campaigns, intensified testing for sexually transmitted infections, and increased contact tracing to control the ongoing monkeypox outbreak.
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Million M, Lagier JC, Tissot-Dupont H, Ravaux I, Dhiver C, Tomei C, Cassir N, Delorme L, Cortaredona S, Amrane S, Aubry C, Bendamardji K, Berenger C, Doudier B, Edouard S, Hocquart M, Mailhe M, Porcheto C, Seng P, Triquet C, Gentile S, Jouve E, Giraud-Gatineau A, Chaudet H, Camoin-Jau L, Colson P, Gautret P, Fournier PE, Maille B, Deharo JC, Habert P, Gaubert JY, Jacquier A, Honore S, Guillon-Lorvellec K, Obadia Y, Parola P, Brouqui P, Raoult D. Early combination therapy with hydroxychloroquine and azithromycin reduces mortality in 10,429 COVID-19 outpatients. Rev Cardiovasc Med 2021; 22:1063-1072. [PMID: 34565108 DOI: 10.31083/j.rcm2203116] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 11/06/2022] Open
Abstract
We evaluated the age-specific mortality of unselected adult outpatients infected with SARS-CoV-2 treated early in a dedicated COVID-19 day hospital and we assessed whether the use of hydroxychloroquine (HCQ) + azithromycin (AZ) was associated with improved survival in this cohort. A retrospective monocentric cohort study was conducted in the day hospital of our center from March to December 2020 in adults with PCR-proven infection who were treated as outpatients with a standardized protocol. The primary endpoint was 6-week mortality, and secondary endpoints were transfer to the intensive care unit and hospitalization rate. Among 10,429 patients (median age, 45 [IQR 32-57] years; 5597 [53.7%] women), 16 died (0.15%). The infection fatality rate was 0.06% among the 8315 patients treated with HCQ+AZ. No deaths occurred among the 8414 patients younger than 60 years. Older age and male sex were associated with a higher risk of death, ICU transfer, and hospitalization. Treatment with HCQ+AZ (0.17 [0.06-0.48]) was associated with a lower risk of death, independently of age, sex and epidemic period. Meta-analysis evidenced consistency with 4 previous outpatient studies (32,124 patients-Odds ratio 0.31 [0.20-0.47], I2 = 0%). Early ambulatory treatment of COVID-19 with HCQ+AZ as a standard of care is associated with very low mortality, and HCQ+AZ improve COVID-19 survival compared to other regimens.
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Affiliation(s)
- Matthieu Million
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Jean-Christophe Lagier
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Hervé Tissot-Dupont
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Isabelle Ravaux
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Catherine Dhiver
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Christelle Tomei
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Nadim Cassir
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Léa Delorme
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
| | - Sébastien Cortaredona
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
| | - Sophie Amrane
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
| | - Camille Aubry
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
| | - Karim Bendamardji
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Cyril Berenger
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
| | - Barbara Doudier
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Sophie Edouard
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Marie Hocquart
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
| | - Morgane Mailhe
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Coralie Porcheto
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Piseth Seng
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Catherine Triquet
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Stéphanie Gentile
- EA 3279: CEReSS - Health Service Research and Quality of Life Center, Service d'Evaluation Médicale, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, France
| | - Elisabeth Jouve
- EA 3279: CEReSS - Health Service Research and Quality of Life Center, Service d'Evaluation Médicale, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, France
| | - Audrey Giraud-Gatineau
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
| | - Herve Chaudet
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
| | - Laurence Camoin-Jau
- Laboratoire D'Hématologie, Hôpital de La Timone, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, France
| | - Philippe Colson
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Philippe Gautret
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
| | - Pierre-Edouard Fournier
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
| | - Baptiste Maille
- Service de Cardiologie, Centre Hospitalier Universitaire La Timone, Assistance Publique Hôpitaux de Marseille, Aix Marseille Univ, C2VN, 13005 Marseille, France
| | - Jean-Claude Deharo
- Service de Cardiologie, Centre Hospitalier Universitaire La Timone, Assistance Publique Hôpitaux de Marseille, Aix Marseille Univ, C2VN, 13005 Marseille, France
| | - Paul Habert
- Radiology Department, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, Aix Marseille Univ, LIIE, CERIMED, 13005 Marseille, France
| | - Jean-Yves Gaubert
- Radiology Department, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, Aix Marseille Univ, LIIE, CERIMED, 13005 Marseille, France
| | - Alexis Jacquier
- Radiology Department, La Timone Hospital, Assistance Publique Des Hôpitaux de Marseille, Aix Marseille Univ, LIIE, CERIMED, 13005 Marseille, France
| | - Stéphane Honore
- Service de Pharmacie, Hôpital Timone, Laboratoire de Pharmacie Clinique, Aix Marseille Université AP-HM, 13005 Marseille, France
| | - Katell Guillon-Lorvellec
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Yolande Obadia
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
| | - Philippe Parola
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Service de santé des armées (SSA), 13005 Marseille, France
| | - Philippe Brouqui
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
| | - Didier Raoult
- IHU-Méditerranée Infection, Aix Marseille Univ, Assistance Publique Hôpitaux de Marseille (AP-HM), Institut de recherche pour le développement (IRD), Unité Microbes Evolution Phylogénie et Infections (MEPHI),13005 Marseille, France
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Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Mailhe M, Doudier B, Courjon J, Giordanengo V, Vieira VE, Tissot Dupont H, Honoré S, Colson P, Chabrière E, La Scola B, Rolain JM, Brouqui P, Raoult D. Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. Int J Antimicrob Agents 2020; 56:105949. [PMID: 32205204 PMCID: PMC7102549 DOI: 10.1016/j.ijantimicag.2020.105949] [Citation(s) in RCA: 3180] [Impact Index Per Article: 795.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 03/17/2020] [Accepted: 03/17/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Chloroquine and hydroxychloroquine have been found to be efficient on SARS-CoV-2, and reported to be efficient in Chinese COV-19 patients. We evaluate the effect of hydroxychloroquine on respiratory viral loads. PATIENTS AND METHODS French Confirmed COVID-19 patients were included in a single arm protocol from early March to March 16th, to receive 600mg of hydroxychloroquine daily and their viral load in nasopharyngeal swabs was tested daily in a hospital setting. Depending on their clinical presentation, azithromycin was added to the treatment. Untreated patients from another center and cases refusing the protocol were included as negative controls. Presence and absence of virus at Day6-post inclusion was considered the end point. RESULTS Six patients were asymptomatic, 22 had upper respiratory tract infection symptoms and eight had lower respiratory tract infection symptoms. Twenty cases were treated in this study and showed a significant reduction of the viral carriage at D6-post inclusion compared to controls, and much lower average carrying duration than reported in the litterature for untreated patients. Azithromycin added to hydroxychloroquine was significantly more efficient for virus elimination. CONCLUSION Despite its small sample size, our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin.
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Affiliation(s)
- Philippe Gautret
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Jean-Christophe Lagier
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Philippe Parola
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Van Thuan Hoang
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - Line Meddeb
- IHU-Méditerranée Infection, Marseille, France
| | | | | | - Johan Courjon
- Infectiologie, Hôpital de l'Archet, Centre Hospitalier Universitaire de Nice, Nice, France; Université Côte d'Azur, Nice, France; U1065, Centre Méditerranéen de Médecine Moléculaire, C3M, Virulence Microbienne et Signalisation Inflammatoire, INSERM, Nice, France
| | - Valérie Giordanengo
- Department of Virology, Biological and Pathological Center, Centre Hospitalier Universitaire de Nice, 06200 Nice, France
| | | | - Hervé Tissot Dupont
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Stéphane Honoré
- Service Pharmacie, Hôpital Timone, AP-HM, Marseille, France; Laboratoire de Pharmacie Clinique, Aix Marseille Université, Marseille, France
| | - Philippe Colson
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Eric Chabrière
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Bernard La Scola
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Jean-Marc Rolain
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Philippe Brouqui
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Didier Raoult
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.
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5
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Million M, Lagier JC, Gautret P, Colson P, Fournier PE, Amrane S, Hocquart M, Mailhe M, Esteves-Vieira V, Doudier B, Aubry C, Correard F, Giraud-Gatineau A, Roussel Y, Berenger C, Cassir N, Seng P, Zandotti C, Dhiver C, Ravaux I, Tomei C, Eldin C, Tissot-Dupont H, Honoré S, Stein A, Jacquier A, Deharo JC, Chabrière E, Levasseur A, Fenollar F, Rolain JM, Obadia Y, Brouqui P, Drancourt M, La Scola B, Parola P, Raoult D. Early treatment of COVID-19 patients with hydroxychloroquine and azithromycin: A retrospective analysis of 1061 cases in Marseille, France. Travel Med Infect Dis 2020; 35:101738. [PMID: 32387409 PMCID: PMC7199729 DOI: 10.1016/j.tmaid.2020.101738] [Citation(s) in RCA: 322] [Impact Index Per Article: 80.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND In France, the combination hydroxychloroquine (HCQ) and azithromycin (AZ) is used in the treatment of COVID-19. METHODS We retrospectively report on 1061 SARS-CoV-2 positive tested patients treated for at least three days with the following regimen: HCQ (200 mg three times daily for ten days) + AZ (500 mg on day 1 followed by 250 mg daily for the next four days). Outcomes were death, clinical worsening (transfer to ICU, and >10 day hospitalization) and viral shedding persistence (>10 days). RESULTS A total of 1061 patients were included in this analysis (46.4% male, mean age 43.6 years - range 14-95 years). Good clinical outcome and virological cure were obtained in 973 patients within 10 days (91.7%). Prolonged viral carriage was observed in 47 patients (4.4%) and was associated to a higher viral load at diagnosis (p < .001) but viral culture was negative at day 10. All but one, were PCR-cleared at day 15. A poor clinical outcome (PClinO) was observed for 46 patients (4.3%) and 8 died (0.75%) (74-95 years old). All deaths resulted from respiratory failure and not from cardiac toxicity. Five patients are still hospitalized (98.7% of patients cured so far). PClinO was associated with older age (OR 1.11), severity of illness at admission (OR 10.05) and low HCQ serum concentration. PClinO was independently associated with the use of selective beta-blocking agents and angiotensin II receptor blockers (p < .05). A total of 2.3% of patients reported mild adverse events (gastrointestinal or skin symptoms, headache, insomnia and transient blurred vision). CONCLUSION Administration of the HCQ+AZ combination before COVID-19 complications occur is safe and associated with a very low fatality rate in patients.
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Affiliation(s)
- Matthieu Million
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Jean-Christophe Lagier
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Philippe Gautret
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Philippe Colson
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Pierre-Edouard Fournier
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Sophie Amrane
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | | | | | | | | | | | - Florian Correard
- Aix Marseille Univ., Laboratoire de Pharmacie Clinique, Marseille, France; AP-HM, hôpital Timone, service Pharmacie, Marseille, France
| | - Audrey Giraud-Gatineau
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France; Centre d'Epidémiologie et de Santé Publique des Armées (CESPA), Marseille, France; AP-HM, Marseille, France
| | - Yanis Roussel
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Cyril Berenger
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Nadim Cassir
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Piseth Seng
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | | | | | | | | | - Carole Eldin
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France
| | | | - Stéphane Honoré
- Aix Marseille Univ., Laboratoire de Pharmacie Clinique, Marseille, France; AP-HM, hôpital Timone, service Pharmacie, Marseille, France
| | - Andreas Stein
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Alexis Jacquier
- Department of Radiology and Cardiovascular Imaging, Aix-Marseille Univ., UMR 7339, CNRS, CRMBM-CEMEREM (Centre de Résonance Magnétique Biologique et Médicale-Centre d'Exploration Métaboliques par Résonance Magnétique), Marseille, France
| | - Jean-Claude Deharo
- AP-HM, Aix Marseille Univ., hôpital Timone, Cardiologie, Rythmologie, Marseille, France
| | - Eric Chabrière
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Anthony Levasseur
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Florence Fenollar
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Jean-Marc Rolain
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | | | - Philippe Brouqui
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Michel Drancourt
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Bernard La Scola
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France
| | - Philippe Parola
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Didier Raoult
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ., IRD, AP-HM, MEPHI, Marseille, France.
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Gautret P, Lagier JC, Parola P, Hoang VT, Meddeb L, Sevestre J, Mailhe M, Doudier B, Aubry C, Amrane S, Seng P, Hocquart M, Eldin C, Finance J, Vieira VE, Tissot-Dupont HT, Honoré S, Stein A, Million M, Colson P, La Scola B, Veit V, Jacquier A, Deharo JC, Drancourt M, Fournier PE, Rolain JM, Brouqui P, Raoult D. Clinical and microbiological effect of a combination of hydroxychloroquine and azithromycin in 80 COVID-19 patients with at least a six-day follow up: A pilot observational study. Travel Med Infect Dis 2020; 34:101663. [PMID: 32289548 PMCID: PMC7151271 DOI: 10.1016/j.tmaid.2020.101663] [Citation(s) in RCA: 464] [Impact Index Per Article: 116.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 04/04/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND We need an effective treatment to cure COVID-19 patients and to decrease virus carriage duration. METHODS We conducted an uncontrolled, non-comparative, observational study in a cohort of 80 relatively mildly infected inpatients treated with a combination of hydroxychloroquine and azithromycin over a period of at least three days, with three main measurements: clinical outcome, contagiousness as assessed by PCR and culture, and length of stay in infectious disease unit (IDU). RESULTS All patients improved clinically except one 86 year-old patient who died, and one 74 year-old patient still in intensive care. A rapid fall of nasopharyngeal viral load was noted, with 83% negative at Day7, and 93% at Day8. Virus cultures from patient respiratory samples were negative in 97.5% of patients at Day5. Consequently patients were able to be rapidly discharged from IDU with a mean length of stay of five days. CONCLUSION We believe there is urgency to evaluate the effectiveness of this potentially-life saving therapeutic strategy at a larger scale, both to treat and cure patients at an early stage before irreversible severe respiratory complications take hold and to decrease duration of carriage and avoid the spread of the disease. Furthermore, the cost of treatment is negligible.
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Affiliation(s)
- Philippe Gautret
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Jean-Christophe Lagier
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Philippe Parola
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Van Thuan Hoang
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France; Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - Line Meddeb
- IHU-Méditerranée Infection, Marseille, France
| | | | | | | | | | | | - Piseth Seng
- IHU-Méditerranée Infection, Marseille, France
| | | | - Carole Eldin
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Julie Finance
- Assistance Publique de Marseille, Hôpital Nord, Explorations Fonctionnelles Respiratories, Aix Marseille Université, France
| | | | | | - Stéphane Honoré
- Service de Pharmacie, Hôpital Timone, AP-HM, Marseille, France; Laboratoire de Pharmacie Clinique, Aix Marseille Université, Marseille, France
| | - Andreas Stein
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Matthieu Million
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Philippe Colson
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Bernard La Scola
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Véronique Veit
- Assistance Publique de Marseille, Médecine Interne, Unité de Médecine Aigue Polyvalente (UMAP), France
| | - Alexis Jacquier
- Department of Radiology and Cardiovascular Imaging, Aix-Marseille Université, UMR 7339, CNRS, CRMBM-CEMEREM (Centre de Résonance Magnétique Biologique et Médicale-Centre d'Exploration Métaboliques par Résonance Magnétique), France
| | - Jean-Claude Deharo
- Assistance Publique de Marseille, Hôpital Timone, Cardiologie, Rythomologie, Aix Marseille Université, France
| | - Michel Drancourt
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Pierre Edouard Fournier
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, AP-HM, SSA, VITROME, Marseille, France
| | - Jean-Marc Rolain
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Philippe Brouqui
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France
| | - Didier Raoult
- IHU-Méditerranée Infection, Marseille, France; Aix Marseille Univ, IRD, APHM, MEPHI, Marseille, France.
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Doudier B, Quiles-Tsimaratos N, Arniaud D. Sporotrichoid non-tuberculous mycobacterial infections following anti-TNF treatment. Med Mal Infect 2018; 48:222-225. [DOI: 10.1016/j.medmal.2017.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 11/13/2017] [Accepted: 12/15/2017] [Indexed: 11/24/2022]
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Panassié L, Borentain P, Nafati C, Bernardin G, Doudier B, Thibault V, Gerolami R, Colson P. Fatal fulminant primary hepatitis B virus infections with G1896A precore viral mutants in southeastern France. Clin Res Hepatol Gastroenterol 2012; 36:e1-8. [PMID: 22037043 DOI: 10.1016/j.clinre.2011.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2011] [Revised: 09/05/2011] [Accepted: 09/13/2011] [Indexed: 02/04/2023]
Abstract
Fulminant hepatitis has been shown to occur in about 1% of acute hepatitis B virus (HBV) infections, and its mortality rate is nearly 70%. Specific HBV genotypic features have been pointed out in fulminant acute hepatitis B worldwide, but these associations remain controversial. We describe all four primary HBV infections diagnosed in 2008 in our institution in Marseille, southeastern France, including two fatal cases. HBV genotypes were D or E. Precore G1896A HBV mutants were detected in both fatal fulminant primary HBV infections. Hepatitis B surface antigen and hepatitis B e antigen (HBeAg) were negative in two and three cases, respectively, despite HBV DNA detection. Primary HBV infection remains a cause of death in France. The impact of the precore G1896A mutation on the severity of AHB deserves to be assessed in larger studies in this country.
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Affiliation(s)
- Laure Panassié
- Laboratoire de virologie, pôle des maladies infectieuses et tropicales clinique et biologique, fédération de bactériologie-hygiène-virologie, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 05, France
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9
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Doudier B, Ninove L, Million M, de Lamballerie X, Charrel RN, Brouqui P. [Unusual Toscana virus encephalitis in southern France]. Med Mal Infect 2010; 41:50-1. [PMID: 21050685 DOI: 10.1016/j.medmal.2010.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2009] [Revised: 08/31/2010] [Accepted: 09/30/2010] [Indexed: 12/14/2022]
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10
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Ninove L, Parola P, Baronti C, De Lamballerie X, Gautret P, Doudier B, Charrel RN. Dengue virus type 3 infection in traveler returning from west Africa. Emerg Infect Dis 2010; 15:1871-2. [PMID: 19891895 PMCID: PMC2857216 DOI: 10.3201/eid1511.081736] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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11
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Doudier B, Olano J, Parola P, Brouqui P. Factors contributing to emergence of Ehrlichia and Anaplasma spp. as human pathogens. Vet Parasitol 2010; 167:149-54. [DOI: 10.1016/j.vetpar.2009.09.016] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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12
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Doudier B, Laban D, Cazorla C, Fournier PE, Parola P, Brouqui P. Leptospirosis diagnosed by molecular DNA detection on skin biopsy. BMJ Case Rep 2010; 2010:bcr09.2009.2313. [PMID: 22242069 DOI: 10.1136/bcr.09.2009.2313] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Leptospirosis is one of the most common anthropozoonoses in the world. Humans are accidental hosts who get infected through damaged skin or conjunctiva from environmental sources such as soil and water contaminated by urine or tissues from infected animals. We report the case of a young man for whom the diagnosis was obtained by polymerase chain reaction (PCR) detection from a skin biopsy.
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Affiliation(s)
- Barbara Doudier
- Hopital Nord, Service De Maladies Infectieuses, Chemin Bourrely, Marseille, 13015, France
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13
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Doudier B, Placko-Parola G, Delmont J. Approach to liver abscesses. Infect Dis (Lond) 2010. [DOI: 10.1016/b978-0-323-04579-7.00216-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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14
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Alangaden GJ, Aldape MJ, Allardet-Servent J, Allen UD, Ammerlaan HS, Angelakis E, Artenstein A, Asboe D, Asiedu KB, Atherton JC, Aw TC, Baid-Agrawal S, Bailey R, Bandel C, Barie PS, Barillo DJ, Bart PA, Bayston R, Beard CB, Beeching NJ, Bégué RE, Benhamou Y, Benson CA, Berbari EF, Berendt AR, Bhatta MP, Bille J, Bitnun A, Black FT, Blair I, Blanche S, Bleck TP, Bleeker-Rovers CP, Bleijenberg G, Bloch KC, Bonten MJ, Boucher CA, Bourayou R, Bouza ES, Bowie WR, Brause BD, Brisse S, Britton W, Brook I, Brown DW, Brun-Buisson C, Brust JC, Bryant AE, Bryskier A, Buller RML, Bush K, Calandra T, Cameron DW, Caraël M, Carr MJ, Casas I, Chambers ST, Chiller KG, Chiller TM, Chiodini PL, Chopra I, Chu AC, Chung KK, Clark BM, Clumeck N, Cockerell CJ, Cohen J, Collinge J, Conlon CP, Corey GR, Cross A, Cross JH, Currier J, Curtis CM, Dallabetta G, Davidson RN, Davies J, Day J, Day NP, De Gascun CF, de Wit S, Delmont J, Dennis DT, Diemert DJ, Doganay M, Doherty T, Dolecek C, Donati SY, Dondorp AM, Doudier B, Drancourt M, Drekonja DM, Drew RH, Duker JS, Dummer JS, Edwards CN, Ekkelenkamp MB, Enright MC, Epstein PR, Erard V, Eziefula AC, Feinberg MB, Fenollar F, Fenwick A, Fernandez L, Fierer J, Finch RG, Flexner CW, Fluit AC, Ford-Jones EL, Fournier PE, Fraser V, French MA, Friedland JS, Fritz JM, Furuya EY, Gage KL, Garcia LS, Gastañaduy AS, Ghanem KG, Giannella M, Glaser CA, Glesby MJ, Glover S, Glupczynski Y, Gnann JW, Goddard AF, Goldstein EJ, González IJ, Gorbach SL, Gottstein B, Gowda R, Grabenstein JD, Grange JM, Green MD, Green ST, Greenblatt DT, Greenwood B, Gregson AL, Groll AH, Gupta AK, Gwee KA, Hall W, Hammer SM, Handa S, Hanfelt-Goade D, Harari A, Harris M, Hartman BJ, Hay RJ, Henderson DK, Hensley LE, Herbert L, Hill DR, Hills TJ, Hinze JD, Hirsch HH, Hirschel B, Hoepelman AI, Holland SM, Horgan MM, Howe R, Hughes JM, Hull MW, Inderlied CB, Ison MG, Jenks PJ, Johnson JR, Jones T, Kanno M, Kauffman C, Kelly P, Kendler JS, Keynan Y, Khan AS, Kho GT, Kinghorn GR, Klapper PE, Kluytmans JAJW, Kok M, Koné-Paut I, Krieger JN, Kroes AC, Kroon FP, Kubin CJ, La Rosa AM, Lalani T, Lalloo DG, Lambert H, Landraud L, Lawn SD, Pharm PL, Leone M, Levi I, Levitt AM, Lindquist HDA, Lloyd G, Looney DJ, Lowy FD, Luft BJ, Lynn WA, Macielag MJ, Mackowiak PA, MacPherson PA, Maghraoui-Slim V, Main J, Mallet V, Mangino JE, Manuel O, Marchetti O, Marks K, Marr KA, Martin C, Martín-Rabadán P, Martinez AJ, Mascini EM, Mayer KH, McCormick JB, McGready R, McKendrick MW, Mead S, Mégraud F, Meheus AZ, Meintjes G, Michaels MG, Miles M, Miller A, Mimiaga MJ, Mingeot-Leclercq MP, Mitchell TG, Moise PA, Montaner J, Moore CB, Moreillon P, Morgan-Capner P, Montessori V, Moss P, Muñoz P, Naber KG, Nakhla S, Narain JP, Nathwani D, Newton P, Nguyen C, Nicolle LE, Niederman MS, Noel GJ, Norrby SR, Nosten F, Notarangelo LD, Nyirjesy P, O'Connell PR, Odorico JS, Ong EL, Opal SM, Ormerod LP, Osmon DR, Ottesen EA, Palacios G, Pantaleo G, Papazian L, Parola P, Pascual MA, Patrozou E, Paya C, Peacock SJ, Pechère JC, Perkins MD, Peters B, Pfyffer GE, Pham PA, Piot P, Placko-Parola G, Pol S, Posfay-Barbe KM, Powderly WG, Pozniak A, Prod'hom G, Quinn TC, Rahn DW, Rana AI, Raoult D, Raz R, Razonable R, Read RC, Reynolds SJ, Richardson MD, Robinson CC, Rooijakkers SH, Rosenbluth D, Rosenzweig SD, Rovery C, Rubin RH, Rubinovitch B, Rubins KH, Rubinstein E, Ryan G, Ryder S, Safren S, Sahasrabuddhe VV, Saikku PA, Sakoulas G, Salazar JC, Salvaggio MR, Schaffer K, Schmitz FJ, Schooley RT, Schumacher RF, Scrimgeour EM, Seddon J, Seifert H, Serjeant GR, Sha BE, Shah KV, Shapiro DS, Sheehan G, Shoham S, Simmons CP, Simonsen KA, Singh N, Slack MP, Sobel JD, Sopirala MM, Spacek LA, Sriskandan S, Stanley SL, Steckelberg JM, Stephenson I, Stevens DL, Straus WL, Sturm W, Summerbell RC, Susa JS, Tabrizi SJ, Tack MA, Taplitz R, Tebas P, Temmerman M, Thijsen SF, Thomas LD, Thomson G, Thwaites GE, Tirelli U, Tolkoff-Rubin NE, Tønjum T, Torriani FJ, Townsend GC, Masó GT, Tulkens PM, Tunkel AR, Vaccher E, Vallet-Pichard A, Van Bambeke F, van de Beek D, van der Meer JW, van Loon AM, van Putten J, Vaudaux BP, Vermund SH, Verstraelen H, Verweij P, Viscidi RP, Visvanathan K, Visvesvara GS, von Seidlein L, Wagenlehner FM, Wahl-Jensen V, Walsh TJ, Warhurst DC, Warnock DW, Warrell DA, Warrell MJ, Warris A, Weber R, Weidner W, Weston VC, Whimbey E, Whitby M, White PJ, Whitty CJ, Willems RJ, Williams E, Wilson C, Wilson ME, Winn RE, Winthrop KL, Wiselka MJ, Wisplinghoff H, Wolfe CR, Wood R, Wright N, Yankaskas JR, Zaidi NA, Zenilman JM, Zhang Y, Zuckerman AJ, Zuckerman JN, Zumla A. Contributors. Infect Dis (Lond) 2010. [DOI: 10.1016/b978-0-323-04579-7.00347-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Brescianini A, Chiche L, Grapperon AM, Raveau I, Jean R, Schleinitz N, Doudier B, Durand JM, Harle JR. Syndrome d’hyperlymphocytose CD8 et infection par le VIH : à propos d’un cas de révélation tardive et sévère. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.10.295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Thomas G, Doudier B, Lagier JC, Brouqui P, Parola P. Méningo-encéphalite estivale : penser à Toscana virus. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.03.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Million M, Cazorla C, Doudier B, La Scola B, Parola P, Drancourt M, Brouqui P. Molecular identification of Borrelia crocidurae in a patient returning from Senegal. BMJ Case Rep 2009; 2009:bcr06.2008.0298. [PMID: 21691399 DOI: 10.1136/bcr.06.2008.0298] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Borrelia spp. are pathogens responsible for worldwide tickborne relapsing fever (TBRF). In West Africa, TBRF is due to a single species, Borrelia crocidurae, transmitted by the soft-body tick Ornithodoros sonrai. We report a case of B crocidurae infection in a French tourist in Senegal, diagnosed by molecular biology using 16S rDNA, flaB, and the 16S-23S intergenic spacer. We found six imported cases reported in travellers (since 1999). We review here clinical and molecular aspects and pathophysiology, and discuss diagnostic methods and therapeutic regimens. In the coming years, this emerging disease will be of concern to more and more travellers returning from disease-endemic regions. Thus, physicians must be aware of its presentation and diagnosis, since the spontaneous outcome can be severe, and a simple treatment is effective.
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Affiliation(s)
- Matthieu Million
- Faculté de médecine, Unité des rickettsies-CNRS URMITE 6236, 27, Bd Jean Moulin, Marseille, 13385, France
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Million M, Doudier B, Soussan J, Subtil C, Meunier-Carpentier S, Parola P. Fever and eosinophilia in a returned traveller. Postgrad Med J 2008; 84:613-4. [DOI: 10.1136/pgmj.2007.066530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Badiaga S, Foucault C, Rogier C, Doudier B, Rovery C, Dupont HT, Castro P, Raoult D, Brouqui P. The effect of a single dose of oral ivermectin on pruritus in the homeless. J Antimicrob Chemother 2008; 62:404-9. [PMID: 18456649 DOI: 10.1093/jac/dkn161] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Homeless people commonly present with ectoparasite-based pruritus. We evaluated the efficacy of a single dose of ivermectin to reduce the pruritus prevalence in a homeless population. METHODS We conducted a randomized, double-blind, placebo-controlled trial from January 2006 to April 2006 in two homeless shelters in the city of Marseille, France. Homeless people complaining of pruritus were randomized to receive either ivermectin (24 mg) or placebo. Follow-up visits were planned at day 14 and day 28 after the inclusion to assess the outcome of pruritus. RESULTS Forty-two subjects with pruritus were randomized to the ivermectin group and 40 to the placebo group. On day 14, pruritus was reported by significantly more subjects in the placebo group than those in the ivermectin group for both the per-protocol (PP) population (91.42% versus 68.57%, P = 0.014) and the intention-to-treat (ITT) population (92.5% versus 73.80%, P = 0.038). No significant effect was observed at day 28. Ivermectin was the only independent factor associated with the absence of pruritus at day 14 in both PP population [OR: 4.60 (95% CI:1.13; 18.73), P = 0.033] and ITT population [OR: 4.38 (95% CI: 1.07; 17.77), P = 0.039]. CONCLUSIONS A single dose of oral ivermectin has a transient beneficial effect on the reduction of the prevalence of pruritus in the homeless population. More studies are required to assess the efficacy of multiple repeated treatments with ivermectin to reduce scabies and body lice endemic among homeless people with pruritus and the impact of such treatment on this population.
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Affiliation(s)
- Sékéné Badiaga
- Unité des Rickettsies, CNRS UMR 6020, IFR 48, Faculté de Médecine, 13185 Marseille, France
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Socolovschi C, Doudier B, Pages F, Parola P. [Ticks and human tick-borne diseases in Africa]. Med Trop (Mars) 2008; 68:119-133. [PMID: 18630043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Ticks are obligate hematophagous arthropod parasites that feed on the blood of every class of vertebrates in almost every region of the world. Tick bites can transmit bacterial, viral and parasitic diseases to humans. In this review we describe ticks and human tick-borne diseases in Africa. The first part of this article presents elements linking the morphology and biology of these acarians as well as various aspects of their taxonomy and phylogeny. The next part of the article describes the main human tick borne diseases in Africa with particular focus on spotted fever group rickettsioses, relapsing fever borrelioses, and Crimean-Congo fever. Information is also provided on Q fever and other tick-borne diseases as ehrlichioses, anaplasmoses, Lyme disease, and babesiosis that can and do occur in Africa. Finally this article describes methods used for the collection and identification of ticks and for control and prevention of tick bites as well as essential points for early diagnosis and management of patients who have been bitten by ticks.
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Affiliation(s)
- C Socolovschi
- Centre Collaborateur OMS pour les rickettsioses et les maladies bactériennes vectorisées, Faculté de Médecine, Marseille
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Doudier B, Bogreau H, DeVries A, Ponçon N, Stauffer WM, Fontenille D, Rogier C, Parola P. Possible autochthonous malaria from Marseille to Minneapolis. Emerg Infect Dis 2007; 13:1236-8. [PMID: 17953101 PMCID: PMC2828086 DOI: 10.3201/eid1308.070143] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report 2 cases of Plasmodium falciparum malaria in southern France in a French woman and an American man of Togolese origin who reported no recent travel to malaria-endemic countries. Both infections occurred after a stay near Marseille, which raises the possibility of autochthonous transmission. Entomologic and genotypic investigations are described.
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Doudier B, Rovery C, Rossi P, Feuillet L, Brouqui P. Bickerstaff's brainstem encephalitis: a case report. Med Mal Infect 2007; 37:234-6. [PMID: 17336476 DOI: 10.1016/j.medmal.2006.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2006] [Accepted: 12/08/2006] [Indexed: 10/23/2022]
Abstract
Bickerstaff's brainstem encephalitis (BBE) is a rare diagnosis different from meningoencephalitis with ophthalmoplegia, ataxia and confusion. Less than 100 cases have been described in the literature. We described the fatal case of a 69-year-old man who presented a severe consciousness disorders, distal weakness in the four limbs, and the BBE triad a few days after his admission for pneumonia.
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Affiliation(s)
- B Doudier
- Service des Maladies Infectieuses et Tropicales Hôpital Nord, chemin des Bourrelys, 13915 Marseille, France.
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Landais C, Doudier B, Imbert G, Fenollar F, Brouqui P. Application of rrs gene sequencing to elucidate the clinical significance of Eggerthela lenta infection. J Clin Microbiol 2007; 45:1063-5. [PMID: 17229865 PMCID: PMC1829112 DOI: 10.1128/jcm.01805-06] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Cécile Landais
- Service des Maladies Infectieuses et Tropicales Hôpital Nord, Chemin des Bourrelys, 13915 Marseille, France
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Abstract
Leptospirosis is an anthropozoonosis caused by Leptospira interrogans. It occurs worldwide and is endemic in French Polynesia. Leptospirosis is associated with a large variety of clinical symptoms. Most infections caused by leptospires are either sub-clinical or of very mild severity, but 5-10% of infections result in multiple organ damage, including kidney, liver and lung lesions. Among 71 patients hospitalised in Papeete for severe leptospirosis during a period of 2 years, the main risk-factors for a severe outcome were hypotension, oliguria and an abnormal chest auscultation at the first physical examination. Survival depends on rapid diagnosis and early appropriate management. Well-defined criteria may help physicians to improve the timely treatment of high-risk patients.
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Doudier B, Imbert G, Vitton V, Kahn M, La Scola B. Aeromonas septicaemia: an uncommon complication following placement of transhepatic biliary drainage devices in Europe. J Hosp Infect 2005; 62:115-6. [PMID: 16099547 DOI: 10.1016/j.jhin.2005.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2005] [Accepted: 05/06/2005] [Indexed: 02/07/2023]
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Abstract
Millions of people originating from tropical areas now live outside the country of their birth. As a consequence, the number of cases of diseases imported from the tropics and being seen by European physicians in immigrants is growing. As an example of such diseases, schistosomal appendicitis is a specific trait of infection with Schistosoma haematobium and is an uncommon cause of appendicitis in non-endemic areas. Treatment requires anti-schistomal medication in addition to surgery. Physicians, including surgeons, need to be aware of the possibility of seeing atypical presentations of parasitic diseases in immigrant patients.
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Affiliation(s)
- B Doudier
- Service des Maladies Infectieuses et Tropicales, Center Hospitalo-Universitaire Nord, Marseille, France
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Chandesris MO, Gayet S, Schleinitz N, Doudier B, Harlé JR, Kaplanski G. Infliximab in the treatment of refractory vasculitis secondary to hepatitis C-associated mixed cryoglobulinaemia. Rheumatology (Oxford) 2004; 43:532-3. [PMID: 15024144 DOI: 10.1093/rheumatology/keh080] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Doudier B, Schleinitz N, Hardwigssen J, Saisse J, Veit V, Bernit E, Kaplanski G, Letreut PY, Harlé JR. [Digestive sarcoïdosis: an unusual case revealed by acute ileocecal invagination]. Rev Med Interne 2003; 24:700-2. [PMID: 14550526 DOI: 10.1016/s0248-8663(03)00227-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Veit V, Doudier B, Saisse J, Schleinitz N, Bernit E, Le Treut Y, Harlé J. Sarcoïdose digestive à propos d'une observation révélée par un tableau d'invagination intestinale aiguë. Rev Med Interne 2002. [DOI: 10.1016/s0248-8663(02)80586-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Doudier B, Schieinitz N, Horchowsky N, Jourde N, Voit V, Berbis P, Harlé J. DRESS et lymphome T : Attention à la confusion! Rev Med Interne 2002. [DOI: 10.1016/s0248-8663(02)80250-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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