[Vertebral osteomyelitis due to Streptococcus agalactiae ST-17]. / Spondylodiscite à Streptococcus agalactiae ST-17.

Streptococcus agalactiae has been traditionally considered as associated with neonates and pregnant women. Invasive diseases due to Streptococcus agalactiae are increasing in non-pregnant adults, especially with medical underlying conditions such as diabetes mellitus or neoplasia. Among these invasive manifestations, vertebral osteomyelitis remain exceptional. We report the case of a 49 year old man, without any risk factor, suffering from a vertebral osteomyelitis due to Streptococcus agalactiae. Assessment of virulence factors showed that the strain belonged to the serotype III, sequence type ST-17. The patient recovered well after prolonged antibiotic therapy. Although exceptional and associated with a favourable outcome, this case highlights the potential implication of Group B Streptococcus in vertebral osteomyelitis and the way to manage it.

[About two cases of trichinellosis caused by Trichinella britovi]. / A propos de deux cas de trichinellose à Trichinella britovi.

Trichinellosis is a cosmopolitan zoonosis due to a nematode threadworm, Trichinella, essentially Trichinella spiralis. Human cases mostly appeared sporadically, sometimes endemically, related with consumption of larva stinking meat. We report two cases of trichinellosis, including a myocarditis, caused by Trichinella britovi after consumption of frozen wild boar meat.

[Meningoencephalitis after vaccination against yellow fever with the 17 D strain: 2 cases]. / Méningo-encéphalite après vaccination anti-amarile par la souche 17 D: deux observations.

The authors report two cases of meningoencephalitis consecutive to immunization with the 17 D yellow fever virus in adults. This complication is exceptional; the rare cases previously reported usually occurred in children. The meningoencephalitis had no particular clinical features; it was more severe in our second case but nevertheless followed a favourable course, as usually described in the literature. The pathogenesis of these central nervous system reactions is unclear. In our two cases the vaccine seems to have acted synergistically with another neurotropic virus (adenovirus in the first case, unknown virus in the second) which was either pre-existing and latent or occurring de novo.

Antibodies to histones in rheumatoid arthritis.

Using a newly developed enzyme-linked immunosorbent assay, antibodies to histones (H1, H2A, H2B, H3 and H4) were found in 32 out of 40 rheumatoid arthritis patients with antinuclear antibodies at a titer greater than or equal to 100 as measured by indirect immunofluorescence. The anti-H2A reactivity was higher in patients with secondary Sjögren's syndrome than in those without, but the highest antihistone reactivity and the most heterogeneous patterns were observed in patients who were receiving D-penicillamine.

Listeriosis after fludarabine treatment for chronic lymphocytic leukemia.

The authors report a case of Listeria monocytogenes septicemia in a patient with advanced CLL after a single course of fludarabine, without any other immunosuppressive therapy e.g. corticosteroids. The immunosuppressive action of fludarabine in patients who are already severely immunosuppressed must be considered from a diagnostic and therapeutic point of view. Listeriosis and other opportunistic infections, like pneumocystis carinii pneumonia, have been reported during and after treatment with purine analogues. Prophylaxis with cotrimoxazole must therefore be discussed in patients with CLL treated with fludarabine.