Asunto(s)
Aciclovir/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Cefalosporinas/uso terapéutico , Ciprofloxacina/uso terapéutico , Pancreatitis/tratamiento farmacológico , Virosis/tratamiento farmacológico , Enfermedad Aguda , Adulto , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , Infecciones Bacterianas/complicaciones , Femenino , Humanos , Masculino , Pancreatitis/diagnóstico , Pancreatitis/etiología , Estudios Retrospectivos , Centros de Atención Terciaria , Resultado del Tratamiento , Virosis/complicacionesAsunto(s)
Anticoagulantes/efectos adversos , Hemorragia Gastrointestinal/inducido químicamente , Anciano , Anciano de 80 o más Años , Antitrombinas/efectos adversos , Bencimidazoles/efectos adversos , Dabigatrán , Femenino , Hemorragia Gastrointestinal/diagnóstico , Humanos , Masculino , Morfolinas/efectos adversos , Estudios Retrospectivos , Rivaroxabán , Tiofenos/efectos adversos , beta-Alanina/efectos adversos , beta-Alanina/análogos & derivadosAsunto(s)
Antivirales/uso terapéutico , Guanina/análogos & derivados , Hepatitis B Crónica/complicaciones , Hepatitis B Crónica/tratamiento farmacológico , Hepatitis C Crónica/complicaciones , Hepatitis C Crónica/tratamiento farmacológico , Interferón-alfa/uso terapéutico , Polietilenglicoles/uso terapéutico , Ribavirina/uso terapéutico , Humanos , MasculinoAsunto(s)
Neoplasias de las Glándulas Suprarrenales/secundario , Glándulas Suprarrenales/patología , Carcinoma Hepatocelular/tratamiento farmacológico , Neoplasias Hepáticas/tratamiento farmacológico , Niacinamida/análogos & derivados , Compuestos de Fenilurea/uso terapéutico , Enfermedades de las Glándulas Suprarrenales/inducido químicamente , Enfermedades de las Glándulas Suprarrenales/diagnóstico , Neoplasias de las Glándulas Suprarrenales/patología , Glándulas Suprarrenales/efectos de los fármacos , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Carcinoma Hepatocelular/patología , Hemorragia/inducido químicamente , Hemorragia/diagnóstico , Humanos , Neoplasias Hepáticas/patología , Masculino , Persona de Mediana Edad , Necrosis/inducido químicamente , Necrosis/diagnóstico , Niacinamida/efectos adversos , Niacinamida/uso terapéutico , Compuestos de Fenilurea/efectos adversos , SorafenibAsunto(s)
Virus de la Hepatitis E/genética , Hepatitis E/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Anticuerpos/sangre , ADN Viral/análisis , Femenino , Francia , Genotipo , Hospitales Militares , Humanos , Inmunoglobulina G/inmunología , Inmunoglobulina M/inmunología , Masculino , Persona de Mediana Edad , ARN Viral/análisis , Reacción en Cadena en Tiempo Real de la Polimerasa , Estudios Retrospectivos , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
We report the first case of leptospirosis in a patient with a travel history to Mauritius, where the disease has very occasionally been reported in local populations. Following an initial dengue-like presentation, the patient suffered pancreatic involvement and trigeminal neuralgia, which are two unusual delayed features of leptospirosis.
Asunto(s)
Leptospirosis/diagnóstico , Viaje , Adulto , Francia , Humanos , MauricioRESUMEN
Eosinophil accumulation in the gastrointestinal tract is a common feature of numerous disorders including mainly parasitic infection, drug-induced allergic reactions, inflammatory bowel disease, and various connective tissue disorders. Digestive tissue eosinophilia requires thorough searching for secondary causes that may be specifically treated with antibiotics, dietary and drug elimination or immunosuppressive therapy. Frequency, prognosis and therapeutic implications must guide the diagnostic course. An acute eosinophilic gastroenteritis in a 78-year-old asthmatic woman receiving celecoxib is reported. She presented later with neurologic and cutaneous features and was finally treated by methylprednisolone and cyclophosphamide. The diagnostic approach leading to a Churg-Strauss syndrome (CSS) assertion is described. We discuss the pathogenesis, the management and the potential enhancing role of celecoxib in CSS gastrointestinal involvement.
Asunto(s)
Síndrome de Churg-Strauss/diagnóstico , Enfermedad Aguda , Anciano , Síndrome de Churg-Strauss/complicaciones , Enteritis/etiología , Eosinofilia/etiología , Femenino , Gastritis/etiología , HumanosRESUMEN
Hepatitis E is an emerging imported disease in Europa but autochthonous cases are described for some years. Extra-hepatic associated manifestations are published. We report a case of acute necrotizing pancreatitis associated with imported acute viral E hepatitis (genotype 1a) in a 26 years old French man travelling and originated from Pakistan. The outcome is favourable spontaneously in two months. This life-threatening hepatitis E related complication is unknown in Europa where genotype 3 virus strains prevail. The clinical presentation is stereotyped with the onset of pancreatitis in the second or third weeks of hepatitis evolution in an Indian male in his second or third decade infected with genotype 1 strain. No pancreatitis-related death is reported in the 13 previous reported cases.
Asunto(s)
Hepatitis E/complicaciones , Pancreatitis Aguda Necrotizante/diagnóstico , Pancreatitis Aguda Necrotizante/patología , Viaje , Adulto , Francia , Anticuerpos Antihepatitis/sangre , Humanos , Inmunoglobulina G/sangre , Masculino , Pakistán , ARN Viral/sangre , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Gasto Cardíaco Bajo/complicaciones , Gasto Cardíaco Bajo/terapia , Cardiomiopatía Dilatada/complicaciones , Cardiomiopatía Dilatada/terapia , Hígado/irrigación sanguínea , Marcapaso Artificial , Prurito/etiología , Prurito/terapia , Disfunción Ventricular Izquierda/complicaciones , Disfunción Ventricular Izquierda/terapia , Gasto Cardíaco Bajo/diagnóstico , Cardiomiopatía Dilatada/diagnóstico , Colestasis , Diagnóstico Diferencial , Electrocardiografía Ambulatoria , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/terapia , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Disfunción Ventricular Izquierda/diagnósticoAsunto(s)
Diarrea/epidemiología , Enfermedades Transmitidas por los Alimentos/epidemiología , Enfermedades Gastrointestinales/epidemiología , Giardiasis/diagnóstico , Personal Militar , Diarrea/parasitología , Djibouti/epidemiología , Enfermedades Transmitidas por los Alimentos/parasitología , Francia , Enfermedades Gastrointestinales/parasitología , Giardiasis/epidemiología , Humanos , Vigilancia de la Población , Factores de RiesgoAsunto(s)
Catha/efectos adversos , Estimulantes del Sistema Nervioso Central/efectos adversos , Enfermedad Hepática Crónica Inducida por Sustancias y Drogas/etiología , Hígado/efectos de los fármacos , Adolescente , Adulto , África Oriental/etnología , Animales , Enfermedad Hepática Crónica Inducida por Sustancias y Drogas/etnología , Emigrantes e Inmigrantes , Resultado Fatal , Femenino , Humanos , Hígado/patología , Masculino , Masticación , Persona de Mediana Edad , Países Bajos/epidemiología , Hojas de la Planta/química , Conejos , Trastornos Relacionados con SustanciasRESUMEN
INTRODUCTION: Chronic viral C hepatitis can be cured by shorter treatment than recommended. It is illustrated by our two case reports. CASES: We report two cases of chronic viral C hepatitis cured by short therapy with interferon standard alone in one case and the combination of pegylated-interferon and ribavirin in the second case. Genotype was undetermined for one patient and 3a for the other. DISCUSSION: Excepted genotyping and early testing of viral load decrease during treatment (12th week), we lack early predictive factors of sustained response that could help avoid prolonged, poorly tolerated therapy in future non-responders. These observations show that the treatment duration of chronic viral C hepatitis can be shortened in selected patients, who should be identified as soon as possible after the beginning of the treatment.
Asunto(s)
Antivirales/uso terapéutico , Hepatitis C Crónica/tratamiento farmacológico , Interferón-alfa/uso terapéutico , Polietilenglicoles/uso terapéutico , Ribavirina/uso terapéutico , Adulto , Esquema de Medicación , Quimioterapia Combinada , Humanos , Interferón alfa-2 , Masculino , Proteínas RecombinantesRESUMEN
INTRODUCTION: Hepatitis E virus is endemic in developing countries where it is especially lethal among pregnant women. As the circulation of goods and people grows between these countries and the industrialized nations, this virus is emerging as a cause of imported acute hepatitis in the latter, where authentic autochthonous cases also exist. OBSERVATIONS: We report two cases observed in Marseille, in men aged 27 and 81 years; no mode of contamination was detected, and both outcomes were positive. DISCUSSION: This virus is circulating in non-endemic areas (as shown by its seroprevalence, which ranges from 0.4 to 2.6%, its identification in urban sewage, and the autochthonous cases reported). This dissemination, combined with its high mortality rate, even outside pregnancy (up to 12%), show the need for systematic consideration of and an early search for the often-fleeting presence of the virus and of IgM and IgG type serum antibodies in plasma and (when necessary) feces in cases of acute hepatitis, because of their often transient nature. Prophylaxis is based on improving water hygiene and is thus more difficult in industrialized countries where the level of hygiene is already high, especially when no risk factors can be identified in the autochthonous cases. Recombinant vaccines are under development.