A Lemierre syndrome variant caused by Staphylococcus aureus.

Lemierre syndrome is a rare clinical entity, characterized by thrombosis of the internal jugular vein that develops after an oropharyngeal infection. We report the case of a 22-year-old woman hospitalized initially for cellulitis of the face. In view of the aggravation of the clinical state (septic shock and multiple organ failure), a computed tomography of the neck was performed and revealed a thrombosis of the right internal and external jugular veins. The patient was treated with antibiotics, heparin, and by a surgical excision for the vascular lesions associated with ligation of jugular veins. The patient completely recovered from her infection.

Decrease in circulating dendritic cells predicts fatal outcome in septic shock.

OBJECTIVE: Biomarkers allowing accurate early staging of septic shock patients are lacking despite their obvious interest for patient management. Experimental models of septic shock in mouse previously noted a decrease in dendritic cell numbers. The aim of the study was to find a rapid reproducible biological test for an assessment of disease severity. DESIGN: Evaluation of peripheral blood dendritic cell counts by flow cytometry using three commercially available kits. PATIENTS AND PARTICIPANTS: Forty-two consecutive septic shock patients were studied prospectively. MEASUREMENTS AND RESULTS: Early low dendritic cell counts were correlated to disease severity as assessed by Simplified Acute Physiology Score or Sequential Organ Failure Assessment and predicted fatal outcome. The correlation was still present when the results were adjusted for age. CONCLUSION: The monitoring of blood dendritic cell count may provide an early and valuable assessment of the severity of the host response against infection and may influence the therapeutic management of septic shock patients.

Considering reefscape configuration and composition in biophysical models advance seascape genetics.

Previous seascape genetics studies have emphasized the role of ocean currents and geographic distances to explain the genetic structure of marine species, but the role of benthic habitat has been more rarely considered. Here, we compared the population genetic structure observed in West Pacific giant clam populations against model simulations that accounted habitat composition and configuration, geographical distance, and oceanic currents. Dispersal determined by geographical distance provided a modelled genetic structure in better agreement with the observations than dispersal by oceanic currents, possibly due to insufficient spatial resolution of available oceanographic and coastal circulation models. Considering both habitat composition and configuration significantly improved the match between simulated and observed genetic structures. This study emphasizes the importance of a reefscape genetics approach to population ecology, evolution and conservation in the sea.

Coastal upwelling, circulation and heat balance around New Caledonia's barrier reef.

An outstanding characteristic of New Caledonia upwelling is that most events appear limited to the southern half of the western barrier reef. This north-south difference cannot be explained by alongshore variability of the projected wind stress and no strong evidence for alternative explanations has been proposed. A major objective of this paper is to provide the first dynamical analysis of New Caledonia upwelling and its regional environment, based on numerical simulations. Coastal upwelling around New Caledonia is shown to be modulated by a system of geostrophic currents interacting with the island mass. Upwelling velocities are weaker than expected from the two-dimensional Ekman theory, as Ekman divergence is balanced by "coastal geostrophic convergence". The cooling effect of upwelling is also attenuated by alongshore transport of warm water by the Alis current, reminiscent of the Leeuwin current off Western Australia. Nevertheless, coastal upwelling can locally modify the large-scale surface water heat budget, dominated by meridional advection warming and surface cooling. The upwelled waters appear to be mostly of western origin and are transported below the surface by the Subtropical Counter Current before upwelling off New Caledonia. This appears in sharp contrast with the eastern barrier reef where the general warming by meridional advection of tropical surface waters is accentuated by the vigorous western boundary type Vauban current.

Weather regimes and orographic circulation around New Caledonia.

The local climate and island-scale circulation around New Caledonia is investigated using a 4-km resolution mesoscale atmospheric model in concert with QuikSCAT scatterometer winds at 12.5-km resolution. The mesoscale atmospheric weather regimes are first examined through an objective classification applied to the remote sensed winds for nine warm seasons from 1999 to 2008. Four main weather types are identified. Their corresponding synoptic-scale circulation reveals that they are strongly discernable through the position and intensity of the South Pacific Convergence zone (SPCZ), the mid-latitude systems, and the subtropical jet stream. The link between the mesoscale weather types and the two dominant large-scale modes of variability, namely the Madden-Julian Oscillation (MJO) and the El Niño-Southern Oscillation (ENSO), is also described in terms of their influence on the occurrence of each weather type. It shows that their occurrence is significantly controlled by both MJO and ENSO, through modulation of the SPCZ. The large-scale modes of variability are scaled down to island-scale circulation through synoptic and mesoscale regimes, and are eventually modulated by orographic and thermal control. The island-scale circulation is inferred in this study by applying the compositing method to both observed and simulated winds. Their comparison clearly shows the ability of the mesoscale model to capture the local circulation and its spatial and temporal variability. A scaling analysis conducted from the simulated atmospheric parameters shows that the mountain range of New Caledonia is hydrodynamically steep. As a result of trade-wind obstruction by the mountainous island, the flow is shaped by coastally trapped mesoscale responses, i.e., blocking, flow splitting and corner winds, with a spatial scale of about 150 km. Two main obstacles, Mont Panié and Mont Humboldt play a significant role on the dynamical behavior of the low-level flow, while the diurnal heating cycle in the vicinity of the Mainland strongly modulates the local circulation. Moreover, nocturnal drainage flow of cold air occurs on the leeside slope of Mont Humboldt and inhibits vertical mixing over the ocean, which results in a deceleration of surface winds.