Malassezia furfur-related colonization and infection of central venous catheters. A prospective study in a pediatric intensive care unit.

OBJECTIVE: To determine the incidence of Malassezia furfur-related colonization and infection of central venous catheters. DESIGN: Prospective clinical study. SETTING: A paediatric intensive care unit at a University Hospital. PATIENTS: 66 newborns with central venous catheters for parenteral nutrition including lipid emulsions (Intralipid). METHODS: When a central venous catheter was removed, it was rinsed with 1 ml of physiological saline, transported at ambient temperature to the clinical laboratory and cultured on Dixon's medium. The tip of the central venous catheter was used for a bacteriological study using Maki's technique. In case of suspected sepsis, blood cultures were obtained using an Isolator tube. RESULTS. 74 central venous catheters were included: mean duration of use of a central venous catheters and infusions of lipid emulsion (Intralipid) were 19.3 +/- 10 days and 8.6 +/- 8 days respectively. Only 2 central venous catheters (2.7%) were colonized by Malassezia furfur: (Mf) one in an asymptomatic newborn, and the other in an infected newborn with signs of sepsis, who most probably died at 4 months of age from refractory hypoxia due to pulmonary hypoplasia, but not from Mf sepsis. CONCLUSIONS: The incidence of Malassezia furfur-related colonization of central venous catheters appears to be low but not negligible, which warrants the use of specific culture techniques.

[Imported malaria in Brest hospitals from 1981 to 1990]. / Le paludisme d'importation dans les hôpitaux de Brest de 1981 a 1990.

From 1981 to 1990, 96 confirmed hospital cases of imported malaria occurred in Brest. An important increasing of the annual number was observed in 1986. A high proportion of infection was due to Plasmodium falciparum, mainly from black Africa. Most of the patients was French young men, without or with inadequate chemoprophylaxis. Every case of malaria due to P. falciparum appeared during the 2 months following their return from an endemic area. Two patients had a clinical profile of visceral evolutive malaria and 5 a cerebral malaria. Three patients died.

[Peritoneal cryptococcosis: discussion of clinical facts]. / Cryptococcose péritonéale: discussion d'un fait clinique.

The isolation of Cryptococcus neoformans from peritoneal fluid is a rare event. The authors present the case of a patient with a post-hepatitis cirrhosis and from whom C. neoformans was isolated from the ascitic fluid. The pathogenicity, the origin, the portal of entry of the yeast are discussed.

[A case report of septicaemia due to Campylobacter fetus variety intestinalis on a cancerous patient (author's transl)]. / Un cas de septicémie à Campylobacter fetus variété intestinalis chez un cancéreux.

The authors report a case of Campylobacter fetus septicaemia from a cancerous patient. The bacterium was isolated from three blood cultures. The infection characteristics are briefly discussed.

[The student, the cetacean and swine-fever. A minor epidemic after dissection of a globicephale]. / L'étudiant, le cétacé et le rouget. Une petite épidémie d'érysipéloïde après dépeçage d'un globicéphale

A whale (Globicephalus melas), stranded on the north coast of Finistere, was the origin of a minor epidemic of Baker-Rosenbach erysipeloid. The clinical picture was that usually seen after contamination by marine animals (spiny fish, crabs, molluscs). To our knowledge, this is the first time that a marine mammal has been found to be infected by Erysipelothrix rhusiopathiae.

[Imported malaria in Brest hospitals from 1974 to 1980]. / Le Paludisme d'importation dans les hopitaux de Brest de 1974 à 1980.

From 1974 to 1980, 42 confirmed hospital cases of imported malaria occurred in Brest. For 4 cases, we have no information. For the others, 24 care Europeans and 14 non-Europeans. Among the Europeans, the merchant-seamen are the most exposed group. A high proportion of infections are due to Plasmodium falciparum, mainly from black Africa. One patient had a neuropaludism and three had serious attacks. In about half of patients, the initial diagnosis was not malaria. All cases of P. falciparum were due to lack or inadequate chemoprophylaxis.

[Entamoeba polecki infestation in man. Review of the literature apropos of 2 case in Brest]. / Infestation à Entamoeba polecki chez l'homme. Revue de la littérature à propos d'une observation brestoise.

The authors report the observation of an entamoeba polecki infestation in a French woman in professional contact with pigs. Symptoms do not appear to be attributable to the amoeba-infestation but to an associated salmonellosis. The morphology and the pathogenicity of Entamoeba polecki are discussed.

Zygomycosis caused by Cunninghamella bertholletiae in a kidney transplant recipient.

Infections caused by Cunninghamella bertholletiae are rare but severe. Only 32 cases have been reported as yet, but in 26 of these this species was a contributing cause of the death of the patient. This opportunistic mould in the order Mucorales infects immunocompromized patients suffering from haematological malignancies or diabetes mellitus, as well as solid organ transplant patients. The lung is the organ most often involved. Two cases of primary cutaneous infection have been previously reported subsequent to soft-tissue injuries. We report a case of primary cutaneous C. bertholletiae zygomycosis in a 54-year-old, insulin-dependent diabetic man who was treated with tacrolimus and steroids after kidney transplantation. No extracutaneous involvement was found. In this patient, the infection may have been related to insulin injections. The patient recovered after an early surgical excision of the lesion and daily administration of itraconazole for 2 months. This case emphasizes the importance of an early diagnosis of cutaneous zygomycosis, which often presents as necrotic-looking lesions. Prompt institution of antifungal therapy and rapid surgical intervention are necessary to improve the prospects of patients who have contracted these potentially severe infections.