[Gonococcal conjunctivitis in a young woman]. / Conjonctivite à gonocoque chez une jeune adulte.

We describe the management of a female patient who developed an uncomplicated unilateral purulent conjunctivitis with no other clinical signs. The typical clinical presentation and Gram stain of the discharge suggested gonococcal conjunctivitis, allowing treatment to be initiated. Indeed, a strain of Neisseria gonorrhoeae resistant to penicillin and tetracycline was isolated. In collaboration with the patient's primary care physician, management included lavage of the infected eye, systemic antibiotic treatment with erythromycin and topical antibiotic treatment with azithromycin, followed by local steroid treatment in response to persistent hyperemia, which was discontinued and replaced by azithromycin again because of recurrent discharge. Eleven days after the first consultation, a complete cure was achieved without sequelae, and a final check to rule out a residual gonococcal carrier state is planned. Gonococcal conjunctivitis, a diagnostic and therapeutic emergency, is a potentially blinding sexually transmitted disease with which general practitioners and ophthalmologists are not well aquainted. Although rare in developed countries, its incidence is rising in parallel with the global recrudescence of gonococcal infections. This case of gonococcal conjunctivitis is discussed as a review of the clinical and biological elements necessary for diagnosis and therapeutic management, which must occur as early as possible, taking into account rapidly increasing gonococcal resistance to antimicrobial therapies, so as to interrupt spread of the disease.

[Epidemics of schistosomiasis in military staff assigned to endemic areas: standard diagnostic techniques and the development of real-time PCR techniques]. / Épidémies de bilharziose chez des militaires projetés en zone d'endémie, techniques de diagnostic classique et mise au point de techniques de réaction en chaîne de la polymérase (PCR) en temps réel.

The authors report the results of molecular biology techniques for the early diagnosis of cases (invasion phase) of schistosomiasis during two epidemics occurring during French military projects in the Central African Republic and Madagascar. The use of these techniques in real time for subjects not residing in the endemic area significantly improves the sensitivity of screening. The attack rates of these episodes, according to a case definition that took positive specific PCR results into account, were 59% and 26%. These results are a concrete illustration of the proverb that "yaws begin where the trail stops".