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Salachas C, Gounane C, Beduneau G, Lopinto J, Turpin M, Amiel C, Cuvelier A, Gueudin M, Voiriot G, Fartoukh M. Diagnostic yield of viral multiplex PCR during acute exacerbation of COPD admitted to the intensive care unit: a pilot study. Sci Rep 2024; 14:1057. [PMID: 38212620 PMCID: PMC10784589 DOI: 10.1038/s41598-024-51465-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 01/05/2024] [Indexed: 01/13/2024] Open
Abstract
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is one of the leading causes of admission to the intensive care unit, often triggered by a respiratory tract infection of bacterial or viral aetiology. Managing antibiotic therapy in this context remains a challenge. Respiratory panel molecular tests allow identifying viral aetiologies of AECOPD. We hypothesized that the systematic use of a respiratory multiplex PCR (mPCR) would help antibiotics saving in severe AECOPD. Our objectives were to describe the spectrum of infectious aetiologies of severe AECOPD, using a diagnostic approach combining conventional diagnostic tests and mPCR, and to measure antibiotics exposure. The study was bicentric, prospective, observational, and included 105 critically ill patients with a severe AECOPD of presumed infectious aetiology, in whom a respiratory mPCR with a viral panel was performed in addition to conventional microbiological tests. Altogether, the microbiological documentation rate was 50%, including bacteria alone (19%), respiratory viruses alone (16%), and mixed viruses and bacterial species (16%). The duration of antibiotic therapy was shorter in patients without documented bacterial infection (5.6 vs. 9 days; P = 0.0006). This pilot study suggests that molecular tests may help for the proper use of anti-infective treatments in critically ill patients with severe AECOPD.
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Affiliation(s)
- Costa Salachas
- Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, 4, Rue de La Chine, 75020, Paris, France
| | - Cherifa Gounane
- Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, 4, Rue de La Chine, 75020, Paris, France
| | - Gaëtan Beduneau
- Département de Médecine Intensive Réanimation, Normandie Univ, UNIROUEN, UR 3830, CHU Rouen, 76000, Rouen, France
| | - Julien Lopinto
- Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, 4, Rue de La Chine, 75020, Paris, France
| | - Matthieu Turpin
- Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, 4, Rue de La Chine, 75020, Paris, France
| | - Corinne Amiel
- Assistance Publique - Hôpitaux de Paris, Département de Virologie, Hôpital Tenon, 75020, Paris, France
| | - Antoine Cuvelier
- Normandie Univ, UNIROUEN, UR 3830, CHU Rouen, Service de Soins Intensifs Respiratoires, Rouen, France
| | - Marie Gueudin
- Département de Virologie, Normandie Univ, UNIROUEN, UNICAEN, UMR1311 INSERM DYNAMICURE, CHU Rouen, Rouen, France
| | - Guillaume Voiriot
- Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, 4, Rue de La Chine, 75020, Paris, France
- Sorbonne Université, Paris, France
| | - Muriel Fartoukh
- Assistance Publique - Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, 4, Rue de La Chine, 75020, Paris, France.
- Sorbonne Université, Paris, France.
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Lopinto J, Arrestier R, Peiffer B, Gaillet A, Voiriot G, Urbina T, Luyt CE, Bellaïche R, Pham T, Ait-Hamou Z, Roux D, Clere-Jehl R, Azoulay E, Gaudry S, Mayaux J, Mekontso Dessap A, Canoui-Poitrine F, de Prost N. High-Dose Steroids for Nonresolving Acute Respiratory Distress Syndrome in Critically Ill COVID-19 Patients Treated With Dexamethasone: A Multicenter Cohort Study. Crit Care Med 2023; 51:1306-1317. [PMID: 37199534 DOI: 10.1097/ccm.0000000000005930] [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] [Indexed: 05/19/2023]
Abstract
OBJECTIVES To determine the impact of high doses of corticosteroids (HDCT) in critically ill COVID-19 patients with nonresolving acute respiratory distress syndrome (ARDS) who had been previously treated with dexamethasone as a standard of care. DESIGN Prospective observational cohort study. Eligible patients presented nonresolving ARDS related to severe acute respiratory syndrome coronavirus 2 infection and had received initial treatment with dexamethasone. We compared patients who had received or not HDCT during ICU stay, consisting of greater than or equal to 1 mg/kg of methylprednisolone or equivalent for treatment of nonresolving ARDS. The primary outcome was 90-day mortality. We assessed the impact of HDCT on 90-day mortality using univariable and multivariable Cox regression analysis. Further adjustment for confounding variables was performed using overlap weighting propensity score. The association between HDCT and the risk of ventilator-associated pneumonia was estimated using multivariable cause-specific Cox proportional hazard model adjusting for pre-specified confounders. SETTING We included consecutive patients admitted in 11 ICUs of Great Paris area from September 2020 to February 2021. PATIENTS Three hundred eighty-three patients were included (59 in the HDCT group, 324 in the no HDCT group). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS At day 90, 30 of 59 patients (51%) in the HDCT group and 116 of 324 patients (35.8%) in the no HDCT group had died. HDCT was significantly associated with 90-day mortality in unadjusted (hazard ratio [HR], 1.60; 95% CI, 1.04-2.47; p = 0.033) and adjusted analysis with overlap weighting (adjusted HR, 1.65; 95% CI, 1.03-2.63; p = 0.036). HDCT was not associated with an increased risk of ventilator-associated pneumonia (adjusted cause-specific HR, 0.42; 95% CI, 0.15-1.16; p = 0.09). CONCLUSIONS In critically ill COVID-19 patients with nonresolving ARDS, HDCT result in a higher 90-day mortality.
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Affiliation(s)
- Julien Lopinto
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
- Groupe de Recherche Clinique CARMAS, Université Paris Est Créteil, Créteil, France
| | - Romain Arrestier
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
- Groupe de Recherche Clinique CARMAS, Université Paris Est Créteil, Créteil, France
| | - Bastien Peiffer
- Service de Santé Publique, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Antoine Gaillet
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
- Groupe de Recherche Clinique CARMAS, Université Paris Est Créteil, Créteil, France
| | - Guillaume Voiriot
- Médecine Intensive Réanimation, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Tomas Urbina
- Médecine Intensive Réanimation, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Charles-Edouard Luyt
- Sorbonne University, INSERM, UMRS 1166, ICAN, Institute of Cardiometabolism and Nutrition, Paris, France
- Service de médecine intensive-réanimation, Institut de Cardiologie, Assistance Publique-Hôpitaux de Paris, Sorbonne Université Pitié-Salpêtrière Hospital, Paris, France
| | - Raphaël Bellaïche
- Département d'Anesthésie Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Tái Pham
- Université Paris-Saclay, AP-HP, Service de Médecine Intensive Réanimation, Hôpital de Bicêtre, DMU 4 CORREVE Maladies du Cœur et des Vaisseaux, FHU Sepsis, Le Kremlin-Bicêtre, France
| | - Zakaria Ait-Hamou
- Service de Médecine Intensive Réanimation, Hôpital Cochin, Assistance Publique - Hôpitaux de Paris, Hôpitaux universitaires Paris-Centre, Paris, France
| | - Damien Roux
- Médecine intensive réanimation, Hôpital Louis Mourier, Assistance Publique - Hôpitaux de Paris, Colombes, France
- Université Paris Cité, INSERM, CNRS, Institut Necker Enfants Malades, Paris, France
| | - Raphaël Clere-Jehl
- Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Hôpitaux universitaires Paris-Nord, Paris, France
| | - Elie Azoulay
- Hôpital Saint-Louis, Assistance Publique - Hôpitaux de Paris, Hôpitaux universitaires Paris-Nord, Paris, France
| | - Stéphane Gaudry
- Réanimation médico-chirurgicale, Hôpital Avicenne, Assistance Publique - Hôpitaux de Paris, Université Sorbonne Paris Nord, Bobigny, France
| | - Julien Mayaux
- Service de Médecine Intensive Réanimation et Pneumologie, Hôpital Pitié-Salpêtrière Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Armand Mekontso Dessap
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
- Groupe de Recherche Clinique CARMAS, Université Paris Est Créteil, Créteil, France
| | | | - Nicolas de Prost
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
- Groupe de Recherche Clinique CARMAS, Université Paris Est Créteil, Créteil, France
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Turpin M, Tuffet S, Verdet C, Lopinto J, Djibré M, Lassel L, Camuset J, Dupeyrat S, Hafiani M, Quesnel C, Assouad J, Voiriot G, Rousseau A, Fartoukh M. Diagnostic value of molecular tests for the management of postoperative pneumonia in thoracic surgery. J Infect 2023; 86:391-393. [PMID: 36736742 DOI: 10.1016/j.jinf.2023.01.037] [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: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 02/04/2023]
Affiliation(s)
- Matthieu Turpin
- Faculté de médecine, Sorbonne Université, France; Service de Médecine Intensive Réanimation, Hôpital Tenon, Assistance Publique - Hôpitaux de Paris, Paris, France.
| | - Sophie Tuffet
- Faculté de médecine, Sorbonne Université, France; Unité de Recherche Clinique (URC-Est), Hôpital Saint-Antoine, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Charlotte Verdet
- Faculté de médecine, Sorbonne Université, France; Service de Bactériologie, Hôpital Saint-Antoine, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Julien Lopinto
- Faculté de médecine, Sorbonne Université, France; Service de Médecine Intensive Réanimation, Hôpital Tenon, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Michel Djibré
- Faculté de médecine, Sorbonne Université, France; Service de Médecine Intensive Réanimation, Hôpital Tenon, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Ludovic Lassel
- Faculté de médecine, Sorbonne Université, France; Service des Maladies Infectieuses et Tropicales, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Juliette Camuset
- Faculté de médecine, Sorbonne Université, France; Service de Chirurgie Thoracique et Vasculaire, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Sophie Dupeyrat
- Faculté de médecine, Sorbonne Université, France; Service d'Anesthésie, Réanimation et Médecine Péri-opératoire, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Medhi Hafiani
- Faculté de médecine, Sorbonne Université, France; Service d'Anesthésie, Réanimation et Médecine Péri-opératoire, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Christophe Quesnel
- Faculté de médecine, Sorbonne Université, France; Service d'Anesthésie, Réanimation et Médecine Péri-opératoire, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Jalal Assouad
- Faculté de médecine, Sorbonne Université, France; Service de Chirurgie Thoracique et Vasculaire, Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Guillaume Voiriot
- Faculté de médecine, Sorbonne Université, France; Service de Médecine Intensive Réanimation, Hôpital Tenon, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Alexandra Rousseau
- Faculté de médecine, Sorbonne Université, France; Unité de Recherche Clinique (URC-Est), Hôpital Saint-Antoine, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Muriel Fartoukh
- Faculté de médecine, Sorbonne Université, France; Service de Médecine Intensive Réanimation, Hôpital Tenon, Assistance Publique - Hôpitaux de Paris, Paris, France
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Lopinto J, Gendreau S, Berti E, Bartolucci P, Habibi A, Mekontso Dessap A. Effects of corticosteroids in patients with sickle cell disease and acute complications: a systematic review and meta-analysis. Haematologica 2022; 107:1914-1921. [PMID: 35021607 PMCID: PMC9335109 DOI: 10.3324/haematol.2021.280105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Indexed: 11/12/2022] Open
Abstract
Whether corticosteroids improve outcome in patients with acute complications of sickle cell disease (SCD) is still debated. We performed a systematic review of the literature with the aim of estimating effects of corticosteroids on the clinical course of vaso-occlusive crisis (VOC) or acute chest syndrome (ACS) in patients with SCD. The primary outcome was transfusion requirement during hospitalization. Studies were identified by search of MEDLINE and CENTRAL database. Three randomized clinical trials (RCT) and three retrospective cohort studies (RCS) were included, involving 3,304 participants and 5,562 VOC or ACS episodes. There was no difference between corticosteroids and standard treatment regarding transfusion requirement overall (odds ratio [OR]=0.98, 95% confidence interval [CI]: 0.38-2.53) but there was a significant interaction of the study type (P<0.0001): corticosteroid therapy was associated with a lower risk of transfusion in RCT (OR=0.13, 95% CI: 0.04-0.45) and a higher risk of transfusion in RCS (OR=2.12, 95% CI: 1.33-3.40. In RCT, the length of hospital stay was lower with corticosteroids as compared with standard treatment: mean difference - 24 hours (95% CI: -35 to -14). Corticosteroids were associated with an increased risk of hospital readmission as compared with standard treatment, in RCT, RCS, and the entire cohort: OR=5.91, 95% CI: 1.40-24.83; OR=3.28, 95% CI: 1.46-7.36 and OR=3.21, 95% CI: 1.97-5.24, respectively. Corticosteroids were associated with reduced number of transfusions and length of stay in RCT but not in RCS, with more rehospitalizations overall. Additional RCT should be conducted while minimizing the risk of re-hospitalizations.
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Affiliation(s)
- Julien Lopinto
- AP-HP, Hopitaux Universitaires Henri-Mondor, Service de Medecine Intensive Reanimation, F-94010, Creteil, France; Univ Paris Est Creteil, CARMAS, Creteil, F-94010, France.
| | - Segolene Gendreau
- AP-HP, Hopitaux Universitaires Henri-Mondor, Service de Medecine Intensive Reanimation, F-94010, Creteil, France; Univ Paris Est Creteil, CARMAS, Creteil, F-94010, France
| | - Enora Berti
- AP-HP, Hopitaux Universitaires Henri-Mondor, Service de Medecine Intensive Reanimation, F-94010, Creteil, France; Univ Paris Est Creteil, CARMAS, Creteil, F-94010, France
| | - Pablo Bartolucci
- Univ Paris Est Creteil, INSERM, IMRB, FHU SENEC, Creteil, F-94010, France; Univ paris Est Creteil, Centre de reference des Syndrome drepanocytaire Majeurs, Unite des Maladies Genetiques du Globule Rouge (UMGGR)
| | - Anoosha Habibi
- Univ Paris Est Creteil, INSERM, IMRB, FHU SENEC, Creteil, F-94010, France; Univ paris Est Creteil, Centre de reference des Syndrome drepanocytaire Majeurs, Unite des Maladies Genetiques du Globule Rouge (UMGGR)
| | - Armand Mekontso Dessap
- AP-HP, Hopitaux Universitaires Henri-Mondor, Service de Medecine Intensive Reanimation, F-94010, Creteil, France; Univ Paris Est Creteil, CARMAS, Creteil, F-94010, France; Univ Paris Est Creteil, INSERM, IMRB, FHU SENEC, Creteil, F-94010, France
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Elabbadi A, Voiriot G, Tristan A, Gibelin A, Verdet C, Djibré M, Santin A, Jutant EM, Lopinto J, Vandenesch F, Lionnet F, Fartoukh M. Lower respiratory tract infection with Staphylococcus aureus in sickle-cell adult patients with severe acute chest syndrome - the STAPHACS Study. Haematologica 2021; 106:3236-3239. [PMID: 34525793 PMCID: PMC8634178 DOI: 10.3324/haematol.2021.278827] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Indexed: 11/10/2022] Open
Affiliation(s)
- Alexandre Elabbadi
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Paris.
| | - Guillaume Voiriot
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Paris, France; Groupe de Recherche Clinique CARMAS, Collegium Galilée, Créteil
| | - Anne Tristan
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, F-69004, Lyon, France; CIRI, Centre International de Recherche en Infectiologie; Inserm U1111; Université Lyon 1; École Normale Supérieure de Lyon; CNRS UMR5308, F-69008, Lyon
| | - Aude Gibelin
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Paris
| | - Charlotte Verdet
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Service de bactériologie, Hôpital Saint-Antoine, Paris
| | - Michel Djibré
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Paris
| | - Aline Santin
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Service de médecine interne, Centre de Référence de la Drépanocytose, Hôpital Tenon, Paris
| | - Etienne-Marie Jutant
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Paris
| | - Julien Lopinto
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Paris
| | - François Vandenesch
- Centre National de Référence des Staphylocoques, Institut des Agents Infectieux, Hospices Civils de Lyon, F-69004, Lyon, France; CIRI, Centre International de Recherche en Infectiologie; Inserm U1111; Université Lyon 1; École Normale Supérieure de Lyon; CNRS UMR5308, F-69008, Lyon
| | - François Lionnet
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Service de médecine interne, Centre de Référence de la Drépanocytose, Hôpital Tenon, Paris
| | - Muriel Fartoukh
- Sorbonne Université, Assistance Publique - Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Paris, France; Groupe de Recherche Clinique CARMAS, Collegium Galilée, Créteil
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Lopinto J, Elabbadi A, Gibelin A, Voiriot G, Fartoukh M. Infectious aetiologies of severe acute chest syndrome in sickle-cell adult patients, combining conventional microbiological tests and respiratory multiplex PCR. Sci Rep 2021; 11:4837. [PMID: 33649379 PMCID: PMC7921101 DOI: 10.1038/s41598-021-84163-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 01/27/2021] [Indexed: 02/02/2023] Open
Abstract
Acute chest syndrome (ACS) is the most serious complication of sickle cell disease. The pathophysiology of ACS may involve lower respiratory tract infection (LRTI), alveolar hypoventilation and atelectasis, bone infarcts-driven fat embolism, and in situ pulmonary artery thrombosis. One of the most challenging issues for the physicians is to diagnose LRTI as the cause of ACS. The use of a respiratory multiplex PCR (mPCR) for the diagnosis of LRTI has not been assessed in sickle-cell adult patients with ACS. To describe the spectrum of infectious aetiologies of severe ACS, using a diagnostic approach combining conventional tests and mPCR. A non-interventional monocenter prospective study involving all the consecutive sickle-cell adult patients with ACS admitted to the intensive care unit (ICU). Microbiological investigation included conventional tests and a nasopharyngeal swab for mPCR. Altogether, 36 patients were enrolled, of whom 30 (83%) had complete microbiological investigations. A bacterial microorganism, mostly Staphylococcus aureus (n = 8), was identified in 11 patients. There was no pneumonia-associated intracellular bacterial pathogen. A respiratory virus was identified in six patients. Using both conventional tests and nasopharyngeal mPCR, a microbiological documentation was obtained in half of adult ACS patients admitted to the ICU. Pyogenic bacteria, especially S. aureus, predominated.
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Affiliation(s)
- Julien Lopinto
- Assistance Publique-Hôpitaux de Paris, Service de Médecine intensive réanimation, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France.,Sorbonne Université, UFR Médecine, Paris, France
| | - Alexandre Elabbadi
- Assistance Publique-Hôpitaux de Paris, Service de Médecine intensive réanimation, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France
| | - Aude Gibelin
- Assistance Publique-Hôpitaux de Paris, Service de Médecine intensive réanimation, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France
| | - Guillaume Voiriot
- Assistance Publique-Hôpitaux de Paris, Service de Médecine intensive réanimation, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France.,Sorbonne Université, UFR Médecine, Paris, France
| | - Muriel Fartoukh
- Assistance Publique-Hôpitaux de Paris, Service de Médecine intensive réanimation, Hôpital Tenon, 4, rue de la Chine, 75020, Paris, France. .,Sorbonne Université, UFR Médecine, Paris, France.
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Abstract
In this visual case of Strongyloides stercoralis disseminated infection with Enterobacteriaceae-related invasive infection, we demonstrated the in-host S. stercoralis circulation with DNA found in different fluids and specimens, but also in cerebrospinal fluid (CSF), supporting the role of migrant larvae in the Enterobacteriaceae-related invasive and central nervous system infection.
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Affiliation(s)
- Ambroise Le Pogam
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, Paris, France
| | - Julien Lopinto
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, Paris, France
| | - Adrien Pecriaux
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service Anatomie et Cytologie Pathologiques, Hôpital Saint-Antoine, Paris, France
| | - Muriel Fartoukh
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, Paris, France
| | - Juliette Guitard
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de Mycologie-Parasitologie, Hôpital Saint-Antoine, Paris, France
- Sorbonne Université, INSERM UMR S 938, Centre de Recherche Saint Antoine (CRSA), Paris, France
| | - Guillaume Voiriot
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de Médecine Intensive Réanimation, Hôpital Tenon, Paris, France
- * E-mail:
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8
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Affiliation(s)
- Guillaume Voiriot
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, 4 rue de la Chine, 75020, Paris, France.
| | - Anne Fajac
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service d'anatomie et cytologie pathologiques, Hôpital Tenon, Paris, France
| | - Julien Lopinto
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, 4 rue de la Chine, 75020, Paris, France
| | - Vincent Labbé
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, 4 rue de la Chine, 75020, Paris, France
| | - Muriel Fartoukh
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, 4 rue de la Chine, 75020, Paris, France
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9
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Lopinto J, Teulier M, Milon A, Voiriot G, Fartoukh M. Severe hemoptysis in post-tuberculosis bronchiectasis precipitated by SARS-CoV-2 infection. BMC Pulm Med 2020; 20:244. [PMID: 32928157 PMCID: PMC7488635 DOI: 10.1186/s12890-020-01285-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 06/12/2020] [Accepted: 09/07/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Since the beginning of SARS-CoV-2 outbreak in China, severe acute respiratory syndrome has been widely descripted. Hemoptysis has rarely been observed in SARS-CoV-2 infection. We report here a case of severe hemoptysis in post-tuberculosis bronchiectasis precipitated by SARS-CoV-2 infection and managed in a referral center. CASE PRESENTATION A 58-year-old man was admitted to our intensive care unit for severe hemoptysis with history of post-tuberculosis bronchiectasis. At ICU admission the patient had fever and severe acute respiratory failure requiring high flow oxygen therapy. Respiratory tract sampling was positive for SARS-CoV-2. Multi-detector computed tomography angiography pointed out localized bronchiectasis on the left lower lobe and enlarged left bronchial and phrenic arteries; bronchial arteriography with distal embolization was performed with favorable outcome and no bleeding recurrence. CONCLUSIONS To our knowledge, this is the first case of acute exacerbation of bronchiectasis related to SARS-CoV-2 infection and complicated by severe hemoptysis. Whether the virus may play a role in the dysregulation of airway haemostasis, and contribute to episodes of hemoptysis in patients with chronic pulmonary diseases and predisposing factors might be investigated.
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Affiliation(s)
- Julien Lopinto
- Intensive Care Unit, Tenon Hospital, Assistance Publique - Hôpitaux de Paris, 4, rue de la Chine, 75020, Paris, France.
| | - Marion Teulier
- Intensive Care Unit, Tenon Hospital, Assistance Publique - Hôpitaux de Paris, 4, rue de la Chine, 75020, Paris, France
| | - Audrey Milon
- Department of Radiology, Tenon Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Guillaume Voiriot
- Intensive Care Unit, Tenon Hospital, Assistance Publique - Hôpitaux de Paris, 4, rue de la Chine, 75020, Paris, France
| | - Muriel Fartoukh
- Intensive Care Unit, Tenon Hospital, Assistance Publique - Hôpitaux de Paris, 4, rue de la Chine, 75020, Paris, France
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Labat E, Benderra MA, Choukroun D, Lopinto J, Voiriot G. Massive hemoptysis due to a candida-related pulmonary artery pseudoaneurysm. Intensive Care Med 2019; 46:1470-1471. [PMID: 31802142 DOI: 10.1007/s00134-019-05881-x] [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: 11/22/2019] [Accepted: 11/26/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Elsa Labat
- Assistance Publique, Hôpitaux de Paris, Service d'oncologie médicale et de thérapie cellulaire, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Marc-Antoine Benderra
- Assistance Publique, Hôpitaux de Paris, Service d'oncologie médicale et de thérapie cellulaire, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Deborah Choukroun
- Assistance Publique, Hôpitaux de Paris, Service d'anatomie et cytologie pathologiques, Hôpital Tenon, Sorbonne Université, Paris, France
| | - Julien Lopinto
- Assistance Publique, Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France
| | - Guillaume Voiriot
- Assistance Publique, Hôpitaux de Paris, Service de médecine intensive réanimation, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France.
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Dutta P, Mesina C, Lopinto J, Judy K, O'Rourke D, LeRoux P, Ingram M, Lustig R. GliaSite Brachytherapy for Treatment of Recurrent Malignant Gliomas and Metastases: A Retrospective Single-institutional Analysis. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.710] [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: 11/29/2022]
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Abstract
Following alveolar ridge grafting procedures for ridge preservation, for example, the immediate filling of extraction sockets, and ridge augmentation, for example, the building up of the atrophic jawbone, punch biopsies were obtained at various times postextraction prior to the placement of endosseous root-form implants. These histological sections provided an opportunity to study the bony regenerative response to an osteoconductive synthetic graft material and longer term interactions over a period from 8 months to 12 years. The formation and remodeling of healthy dense lamina of bone in areas where bone voids previously existed either from healed or immediate extraction sockets or where there was jawbone atrophy resulting from multiple tooth loss was observed. The grafting procedures enabled dentists to place implants into sites that would have been impossible if not for these preimplant grafting procedures. The jawbone areas studied involved grafted single sites and quadrants as well as full arch augmentation with a calcified microporous copolymer (Bioplant HTR Synthetic Bone, Bioplant Inc, South Norwalk, Conn) graft material. Retrospective case reports of 24 patients were followed radiographically and clinically to 12 years post-alveolar-ridge grafting and subsequently to 5 years after implants were placed into these augmented ridges. Implant and grafting histories from 4.7 months to 17 years are reported for three of these patients. General applications of synthetic bone grafting before implant placement are recommended.
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Affiliation(s)
- A Ashman
- Ashman Department of Implant Dentistry, New York University, College of Dentistry, USA
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