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Abstract
Lactobacillus is a Gram positive bacteria found in the mouth, gastrointestinal and female genital tract. Serious infections due to Lactobacillus are becoming increasingly common. We present a 49-year-old diabetic patient with Lactobacillus septic arthritis. To our knowledge, this is the first reported case. Usually, Lactobacillus is implicated with bacteremia, endocarditis and more rarely pneumonia, meningitis and endovascular infection, and half of the cases are reported in immunocompromised patients. As in our patient, diabetes mellitus is a comorbid condition which has been clearly noted. Our finding suggests that further studies are necessary to establish the significance of Lactobacillus as an etiologic agent of septic arthritis.
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Affiliation(s)
- V Chanet
- Service de Médecine Interne, Boulevard Léon Malfreyt, Hôtel Dieu, Clermont Ferrand 1, France.
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Chanet V, Amarger S, Pons B, Déchelotte P, Ruivard M, Philippe P. [Nodular thrombophlebitis and granulomatous systemic disease]. Rev Med Interne 2007; 28:416-9. [PMID: 17349722 DOI: 10.1016/j.revmed.2007.01.026] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2006] [Revised: 01/28/2007] [Accepted: 01/31/2007] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Nodular thrombophlebitis is septal hypodermitis characterised by vasculitis with vein thrombosis. It may indicate serious underlying disorders. EXEGESIS We present two cases of nodular superficial phlebitis, which revealed tuberculosis and sarcoidosis. CONCLUSION Nodular thrombophlebitis are classic during evolution of Behçet disease or Buerger vasculitis. In sarcoidosis, erythema nodosum and granulomatous involvement are the most common cutaneous manifestation. Nodular thrombophlebitis has never been described. Panniculitis are classical in tuberculosis. But most cases are erythema nodosum and cases of erythema induratum of Bazin. Nodular thrombophlebitis could reveal thrombophilic abnormalities, and even more neoplasms especially when they are recurrent and migratory.
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Affiliation(s)
- V Chanet
- Service de Médecine Interne, Pôle Santé République, 105, avenue de la République, 63000 Clermont-Ferrand, France.
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Vidal M, Corbin V, Chanet V, Ruivard M, Gourdon F, Laurichesse H, Beytout J, Lesens O. Infections associées à des évènements thrombotiques sévères avec présence d'anticorps antiphospholipides. Med Mal Infect 2005; 35:552-5. [PMID: 16253461 DOI: 10.1016/j.medmal.2005.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [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: 05/11/2005] [Accepted: 08/30/2005] [Indexed: 11/16/2022]
Abstract
The authors present 2 cases of infections in which the presence of antiphospholipid antibodies (APL), anticardiolipin and anti-beta2-GP1, was associated to the occurrence of significant thrombotic events: 1) a 55-year-old male patient whose serology (indirect immunofluorescence) revealed Coxiella burnetii infection (phase 2 antigens) with IgG at 1,600 and IgM at 50 (significant titer: IgG>or=200 and IgM>or=50); 2) and a 20-year-old male patient with a CMV infection confirmed by serology (IgG: 44 U/ml, significant threshold 6, IgM: 2.1 U/ml, significant threshold 0.9).
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Affiliation(s)
- M Vidal
- Service de maladies infectieuses et tropicales, Hôtel-Dieu, CHU de Clermont-Ferrand, boulevard Léon-Malfreyt, 63000 Clermont-Ferrand, France
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Abstract
OBJECTIVES To see if a past history of radiation therapy is a risk factor for septic arthritis. METHODS We retrospectively searched our records of 282 patients with septic arthritis and found 10 cases of septic arthritis post-radiotherapy, all in females. We analysed our group, correlating them with the literature. We also compared our patients with a group of septic arthritis patients without radiation therapy. RESULTS Nine had had radiation therapy for carcinoma of the breast. The shoulder joint was involved in six and the sternoclavicular joint in three. The tenth patient had had brachytherapy and radiation for carcinoma of the cervix and presented with septic arthritis of the hip. The mean age of the patients was 69 yr (49-82 yr). The mean time elapsed since radiation was 16 yr (3-34 yr). Twenty-three cases of shoulder septic arthritis in patients without past radiation therapy were selected for comparison. The five patients with past radiation therapy had fever less often and a longer time lapse before diagnosis. They required longer antibiotherapy. However, this prevented neither bone destruction nor relapse. CONCLUSIONS In our study, a past history of radiation therapy was observed in 6/50 infections of the shoulder, 3/5 infections of the sternoclavicular joint, 6/23 cases of septic arthritis of the shoulder and all cases of septic arthritis of the sternoclavicular joint for females. Radiation therapy seems to be a risk factor for septic arthritis. Diagnosis would be aided by a greater awareness of the clinical and radiological features of this septic arthritis.
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Affiliation(s)
- V Chanet
- Immunology and Rheumatology Department (B. SAUVEZIE), Clermont-Ferrand, France.
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Letranchant L, Ruivard M, Dauphin C, Chanet V, Philippe P. [Non infectious endocarditis: retrospective study (6 cases)]. Rev Med Interne 2005; 26:189-95. [PMID: 15777581 DOI: 10.1016/j.revmed.2004.11.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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: 06/16/2004] [Accepted: 11/29/2004] [Indexed: 11/25/2022]
Abstract
PURPOSE If there is cardiac valve vegetation and the blood cultures are negatives we need to look for slow growing bacteria, fungi, Legionella pneumophilia, Bartonella henselae and quintana, Brucella melitensis and abortus, Coxiella burneti, Chlamydiae pneumoniae by serologic tests. The diagnosis of non- infectious endocarditis could be considered only if these results were negative. The main purpose of this study was to describe the clinical and echocardiographic signs of non-infectious endocarditis cases observed in two different wards. METHODS This study was done retrospectively during a five-year period in a cardiology and an internal medicine wards. The selection criteria are: the proof of at least one cardiac valve vegetation, observed on echocardiography, negative blood cultures and negative serologic tests as described above. RESULTS Six non-bacterial endocarditis were described. Four Libman-Sacks endocarditis, two associated with a primary antiphospholipid syndrome revealed by an acute ischemia of leg for one patient and by an eclampsia for another and the other two associated with a systemic lupus erythematous revealed by fever for one patient and by neurologic symptoms for the other. One fibroblastic endocarditis associated to an essential hypereosinophilia and one marastic endocarditis associated to a metastatic mucin-producing cancer. CONCLUSIONS For these six cases, a complete physical examination, a CBC for hypereosinophylia, a dosage of antiphospholipid antibodies and a thoraco-abdominal CT-scan allowed the etiologic diagnosis of non infectious endocarditis. Libman Sacks endocarditis associated with an antiphospholipid syndrome is the main etiology for which a long-term anticoagulation treatment was not followed.
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Affiliation(s)
- L Letranchant
- Service de médecine interne et hématologie, Hôtel-Dieu, CHU de Clermont-Ferrand, boulevard Malfrey, 63038 Clermont-Ferrand cedex 01, France.
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Chanet V, Lesens O, Laurichesse H, Beytout J. [Prevention and infection in adults patients with hyposplenism]. Med Mal Infect 2004; 34:493-8. [PMID: 15620052] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
People with asplenia are at risk for infections due to many causative agents, mainly Streptococcus pneumoniae. Among adults, splenectomy is the most frequent etiology of hyposplenism followed with chronic hematological and connective diseases. Physiopathology of the immunologic impairment due to hyposplenia is multifactorial. Physicians and even patients must be aware of overwhelming sepsis occurring on these conditions. The prognosis of these life-threatening infections is related to the precocity of the treatment onset. These infections, mainly due to S. pneumoniae (50-90% of cases) could be prevented with appropriate precautions. Patients presenting with asplenia must be largely vaccinated against these infectious agents: S. pneumoniae, Haemophilus influenzae b, and possibly Neisseiria meningitidis. Oral phenoxymethylpenicillin seems to be the simplest chemoprophylaxis (despite the global increase of pneumococcal strains with reduced susceptibility). Duration of treatment following splenectomy is discussed: The French medicine agency (AFSSAPS) recommends a 2-year treatment after surgery and for patients having functional hyposplenism (persistency of Howell-Jolly bodies) and/or associated immunodeficiency. Despite these prevention policies, the patient must be informed of the risk of very severe infection.
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Affiliation(s)
- V Chanet
- Service de maladies infectieuses, Hôtel-Dieu, boulevard Léon-Malfreyt, 63000 Clermont-Ferrand, France.
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Chanet V, Fournioux J, Hermier M, Gavet E, Pons B, Ruivard M, Philippe P. [Gastroparesis on a gastric ulcer]. Presse Med 2004; 33:1264-6. [PMID: 15611706 DOI: 10.1016/s0755-4982(04)98903-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION Gastroparesis is the failure of the stomach to empty because of decreased gastric motility. It's a fairly frequent medical problem. Diabetes is the most common known cause. OBSERVATION The first case report is that of an 82 year-old woman, in whom acute gastric distension occurred, evoking a gastric volvulus on the scan. Upper endoscopy revealed gastric ulcers. All symptoms disappeared with medical treatment. The second case report concerns a 37 year-old man who was admitted with signs of occlusion. CT scans revealed acute gastric distension. Emergency surgery revealed no gastric volvulus. Upper endoscopy revealed gastritis and numerous ulcers. The signs regressed with medical treatment. DISCUSSION Our observations are original in their -pseudo-surgical discovery. Acute gastric distension is rare, but must be recognised because of the risk of perforation and rupture of the stomach walls. These case reports are also original in their aetiology. Gastric ulcers are rarely described in this situation. CONCLUSION; Gastroparesis is a frequent situation but potentially severe. A review of the principle signs, aetiology and treatment is made.
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Affiliation(s)
- V Chanet
- Service de médecine interne, boulevard Léon Malfreyt, Hôtel-Dieu, 63000 Clermont-Ferrand.
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Rolain JM, Chanet V, Laurichesse H, Lepidi H, Beytout J, Raoult D. Cat scratch disease with lymphadenitis, vertebral osteomyelitis, and spleen abscesses. Ann N Y Acad Sci 2003; 990:397-403. [PMID: 12860662 DOI: 10.1111/j.1749-6632.2003.tb07399.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.7] [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: 11/30/2022]
Abstract
In this report we describe a 30-year old male patient with vertebral osteomyelitis and spleen abscesses with cat scratch disease. The diagnosis was made on the basis of molecular detection of Bartonella henselae either on lymph node biopsies or on bone biopsy, histology of the lymph node, serology using either our in-house microimmunofluorescence assay or a commercial kit (Focus Technologies). Immunofluorescent detection was also performed directly on slide appositions using a monoclonal antibody. Treatment consisted of administration of antibiotics with rapid clinical improvement and a stabilization of skeletal lesions on the magnetic resonance imaging performed three months later. Twenty two other cases of this unusual manifestation associated with cat scratch disease have been reported in the literature and are reviewed here. Our case represents the second case of osteomyelitis associated with cat scratch disease in which B. henselae has been specifically identified as the etiological agent using several direct and indirect methods.
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Affiliation(s)
- J M Rolain
- Unité des Rickettsies CNRS UMR-A 6020, IFR 48, Faculté de Médecine, Université de la Méditerranée, 13385 Marseille Cedex 05, France
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Gavet F, Astier G, Chanet V, Baud O, Jacomet C, Laurichesse H. La sérologie VIH doit-elle faire partie du bilan de thrombose veineuse profonde? Rev Med Interne 2002. [DOI: 10.1016/s0248-8663(02)80268-5] [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: 10/25/2022]
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Delarbre X, André M, Dalens H, Delèvaux I, Lhoste-Trouilloud A, Tridon A, Schmidt J, Chanet V, Piette JC, Aumaître O. [Ophthalmologic manifestations of systemic vasculitis: report of six cases and review of the literature]. Rev Med Interne 2001; 22:1039-48. [PMID: 11817116 DOI: 10.1016/s0248-8663(01)00469-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [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: 11/20/2022]
Abstract
PURPOSE Study of characteristics of ocular involvement in systemic vasculitis. METHODS We describe six cases of systemic vasculitis with ocular involvement observed between 1992 and 2000. These cases are compared with those reported in the literature. RESULTS Our patients suffered from Wegener's granulomatosis (four cases), periarteritis nodosa and Churg-Strauss syndrome. Ocular manifestations were conjunctivitis, scleritis, orbital pseudotumor, optic neuritis and extraocular muscle palsy. These manifestations are similar to those reported in the literature. Their treatment requires steroids and immunosuppressive drugs. In one of our cases, intravenous immunoglobulins were effective in controlling an optic neuritis. CONCLUSION Ocular involvement in systemic vasculitis may concern any orbital structure. It usually occurs during the course of vasculitis but may be one of its first manifestations. It requires an appropriate treatment to prevent ophthalmic complications and especially blindness.
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Affiliation(s)
- X Delarbre
- Service de médecine interne, hôpital Gabriel-Montpied, BP 69, 63003 Clermont-Ferrand, France
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Chanet V, Dubost JJ, Abergel A, Soubrier M, Darcha C, Sauvezie B. [Nodular regenerative hyperplasia of the liver and polymyositis]. Gastroenterol Clin Biol 2001; 25:713-4. [PMID: 11673739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
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Chanet V, Baud O, Henquel C, Bailly D, Beytout J, Laurichesse H. Spasmes artériels récidivants chez un patient ayant une co-infection VIH-VHC, sous trithérapie. Med Mal Infect 2001. [DOI: 10.1016/s0399-077x(01)00219-0] [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: 11/27/2022]
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Chanet V, Tournilhac O, Dieu-Bellamy V, Boiret N, Spitz P, Baud O, Darcha C, Travade P, Laurichesse H. Isolated spleen agenesis: a rare cause of thrombocytosis mimicking essential thrombocythemia. Haematologica 2000; 85:1211-3. [PMID: 11064471] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
Thrombocytosis is a common feature of myeloproliferative disorders but may also result from various conditions including chronic iron deficiency, hemorrhage, chronic inflammation and splenectomy. We report two cases of secondary thrombocytosis caused by isolated and congenital asplenia, mimicking essential thrombocythemia. These two adult cases of spleen agenesis were unexpected. We conclude that in thrombocytosis without clinical evidence of splenomegaly, attentive screening of blood in search of Howell-Jolly bodies and abdominal ultrasonography should always be performed not only to detect mild spleen enlargement but also to make sure of the presence of this organ.
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Affiliation(s)
- V Chanet
- Fédération des Maladies Infectieuses, Médecine interne et Hématologie Adultes, Hôpital Hôtel Dieu, Clermont-Ferrand, France
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Chanet V, Ruivard M, Roche B, Philippe P. Endocardite à Bartonella henselae. Rev Med Interne 1999. [DOI: 10.1016/s0248-8663(99)80263-x] [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: 10/18/2022]
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Chanet V, Ruivard M, Roche B, Marques-Verdier A, Philippe P. Priapisme révélateur d'un déficit en protéine C. Rev Med Interne 1999. [DOI: 10.1016/s0248-8663(99)80385-3] [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: 10/18/2022]
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André M, Schmidt J, Chanet V, Aumaître O. Ophtalmoplégie douloureuse au cours d'un syndrome de Churg et Strauss. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)80223-3] [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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Baud O, Chanet V, Gourdon F, Toumilhac O, Dydymsky S, Raynaud P, Ruivard M, Laurichesse H. Présentation clinique et traitement des lymphomes malins chez les patients atteints d'infection à VIH: étude rétrospective de 19 cas. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)80174-4] [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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Chanet V, d'Incan M, Mansard S, Lachal C, Franck F, Souteyrand P. Automutilation à type de mastite granulomateuse. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)90295-8] [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: 11/25/2022]
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Baud O, Laurichesse H, Chanet V, Henquell C, Gourdon F, Dydymski S, Cormerais L, Beytout J. Cirrhose hépatique : cause émergente de décès chez les patients atteints de co-infection VIH et hépatite chronique B ou C. Rev Med Interne 1998. [DOI: 10.1016/s0248-8663(98)90160-6] [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] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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