Disseminated Nocardia transvalensis complex and farcinica: First case in an immunocompetent.

Background: Nocardiae is an opportunistic infection mainly of the immunocompromised patient without sparing the immunocompetent subject or without any identified risk factors. They can be localized or disseminated. The extreme rarity of this infection often results in a deleterious diagnostic delay. Case presentation: We report a first case of community acquired pneumonia with asymptomatic disseminated brain abscess due to Nocardia transvalensis/wallacei and farcinica in an immunocompetent man. The patient fully recovered after receiving optimized antimicrobial therapy. Conclusions: This case suggests that health care professionals should always evoke this diagnosis when confronted to atypical community-acquired pneumonia, even in immunocompetent patients.

A Fatal Case Coronavirus Disease 2019 - Associated Acute Hemorrhagic Necrotizing Encephalopathy.

Coronavirus disease 2019 (COVID-19) has been reported in association with a variety of brain imaging findings such as acute hemorrhagic necrotizing encephalopathy. To the best of our knowledge, we are reporting a second case of acute necrotizing hemorrhagic encephalopathy associated with COVID-19, which was fatal in a few hours in a 56-year-old male without a specific history. We claim that this case is important because this case shows that the unconscious patients are potentially infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and might cause the horizontal infection. In order to end the pandemic of SARS-CoV-2 diseases, the diagnosis of the disease must be prompt and not overlook any findings. We think that diffusion magnetic resonance imaging is a promising and useful sequence to evaluate the changes in brain tissue in the acute necrotizing encephalopathy.

Epidemiological profile of COVID-19 in the French overseas department Mayotte, 2020 to 2021.

BackgroundDuring the COVID-19 pandemic, national and local measures were implemented on the island of Mayotte, a French overseas department in the Indian Ocean with critical socioeconomic and health indicators.AimWe aimed to describe the COVID-19 outbreak in Mayotte from March 2020 to March 2021, with two waves from 9 March to 31 December 2020 and from 1 January to 14 March 2021, linked to Beta (20H/501Y.V2) variant.MethodsTo understand and assess the dynamic and the severity of the COVID-19 outbreak in Mayotte, surveillance and investigation/contact tracing systems were set up including virological, epidemiological, hospitalisation and mortality indicators.ResultsIn total, 18,131 cases were laboratory confirmed, with PCR or RAT. During the first wave, incidence rate (IR) peaked in week 19 2020 (133/100,000). New hospitalisations peaked in week 20 (54 patients, including seven to ICU). Testing rate increased tenfold during the second wave. Between mid-December 2020 and mid-January 2021, IR doubled (851/100,000 in week 5 2021) and positivity rate tripled (28% in week 6 2021). SARS-CoV-2 Beta variant (Pangolin B.1.351) was detected in more than 80% of positive samples. Hospital admissions peaked in week 6 2021 with 225 patients, including 30 to ICU.ConclusionThis massive second wave could be linked to the high transmissibility of the Beta variant. The increase in the number of cases has naturally led to a higher number of severe cases and an overburdening of the hospital. This study shows the value of a real-time epidemiological surveillance for better understanding crisis situations.

Acute disseminated encephalomyelitis after dengue.

Dengue fever, transmitted by Aedes aegypti mosquitoes, is one of the most common vector-borne disease. Its incidence is increasing steadily worldwide, becoming a major public health problem in the tropical and subtropical zone. Neurological manifestations after dengue are not very common and acute disseminated encephalomyelitis (ADEM) following dengue infections is rare with a few cases documented in literature. Clinical characteristics and typical lesions of ADEM on magnetic resonance imaging (MRI) of brain along with serologic positivity for dengue usually confirm the diagnosis. We report a case of ADEM which developed as a neurological complication of dengue during an epidemic in a 39-year-old woman.

Health-related quality of life among people living with HIV/AIDS in Togo: individuals and contextual effects.

OBJECTIVE: The objective of this study is to assess the quality of life and to identify factors associated with good global quality of life among people living with HIV/AIDS (PLWHA) in Togo. RESULTS: In total, 880 PLWHA with mean age (standard deviation) of 39.6 (10.1) years, were interviewed. Most of them (78.4%) were female. The global score of quality of life was ranged from 42.6 to 112, with a mean (standard deviation) estimated at 86.3 ± (13.3). More than the three-quarters (76.2%) of the participants had a good global quality of life. In multivariate analysis, secondary education level or higher (adjusted odds ratio = 1.78, 95% confident interval (CI) [1.10-2.85]), living in Kara health region (adjusted odds ratio = 4.39, 95% CI [2.94-6.57]), being on antiretroviral therapy (adjusted odds ratio = 6.99, 95% CI [4.11-11.9]) and HIV sero-status disclosure (adjusted odds ratio = 1.83, 95% CI [1.28-2.61]) were associated with a better overall quality of life (score ≥ 77.3).

Arthrocladium fulminans Arthritis and Osteomyelitis.

Arthrocladium fulminans is the only species in the Arthrocladium genus that has been involved in a previous human infection. To date, only one case of A. fulminans infection in a patient with GATA-2 immunodeficiency has been reported. We here report the second human case and the first case of septic arthritis and osteomyelitis due to A. fulminans in an immunocompetent patient, living in Mayotte, a French island in western Indian Ocean. He was successfully treated with surgical debridement and 6 months of antifungal treatment. This second observation of human invasive disease caused by A. fulminans is an additional argument for the pathogenicity of this rare species.