Reconstitution inflammatory syndrome related to histoplasmosis, with a hemophagocytic syndrome in HIV infection.

Immune reconstitution after initiation of antiretroviral therapy may unmask a latent infection. We report a case of disseminated Histoplasma capsulatum capsulatum infection associated with a hemophagocytic syndrome in an HIV-infected patient, three weeks after initiation of antiretroviral therapy. The immune reconstitution inflammatory syndrome might be a risk factor for hemophagocytosis.

[Aspergillosis]. / Aspergillose.

Aspergillosis, due to moulds belonging to the genus Aspergillus, occurs in patients with residual lung cavities. The clinical manifestations are determined by the host immune response, ranging from a local inflammatory response to the systemic dissemination. Haemoptysis is the most common symptom. The chest X-ray reveals a round mass with a radio-lucent crescent of air. The antifungal treatments are successful.

Six human cyclosporiasis: with general review.

Cyclospora cayetanensis is an emerging coccidian pathogen known in animal since a long time, but recognized in human in last two decade. The present study of cyclosporiasis specified its characteristic features. An epidemiological, clinical and biological retrospective study was carried out on 6 patients, 24 to 67 years old, who complained of diarrhea and weight loss, after a travel abroad. The only pathogenic agent found in every patient was Cyclospora cayetanensis. The patients returned back from Asian countries and from Madagascar. They were cured by Trimethoprim-sulfamethoxazole (TMZ). Diarrhoea was the main symptom of infection by C. cayetanensis. Undoubtedly, transmission occurred by the oro-fecal route, and/or by consumption of infected water or foods. Diagnosis was asserted, recovery of this protozoan parasite in the stools samples. TMZ proved to be the most effective and possibly replaced Ciprofloxacine. The prophylaxis recommended control measure of water supply and foods. Cyclospora should be considered in the assessments of patients with unexplained prolonged diarrhoea, if the investigation for bacterial and parasitological diarrhoea or the traveler's diarrhoea were negative.

[Parasitic diseases and pregnancy]. / Maladies parasitaires et grossesse.

In tropical areas, parasitic diseases are very frequent during pregnancy. Malaria is the most frequent, with different complications in pregnant women (anaemia, cerebral malaria, abortion) and in the fetus (low birthweight, congenital malaria), mostly after first pregnancies. Diagnosis must be confirmed rapidly and the treatment is effective with most of antimalarial drugs. Prophylaxis is possible by intermittent sulfadoxine-pyrimethamine treatment. Hookworms infestation increases the anemia. Schistosomiasis can be liable to sterility or dystocia. Congenital transmission of visceral leishmaniasis is exceptional. Digestive parasitosis give few repercussion on pregnancy and their treatment is useful only if clinical troubles are important.

[Parasitic diarrhea]. / Diarrhées parasitaires.

After a trip to tropical areas, diarrhea is frequent and is most often due to a parasite. Amebiasis is the principal cause of acute diarrhea. The other intestinal parasites cause chronic diarrhea, including in temperate countries; these include Giardia, Cryptosporidium, and Microsporidium species in immunocompromised patients. Helminthic diseases, either cosmopolitan (Ascaris, Enterobius, and Taenia) or tropical (hookworms, Strongyloides, and Schistosoma), cause diarrhea with blood hypereosinophilia. Diagnosis is based on the examination of stool. Treatment is rapid, effective and well tolerated, while prophylaxis is often difficult to explain to the populations concerned.

Spinal cord cysticercosis: a case report.

Cysticercosis caused by the infection with the larva of Taenia solium, common through out the world, is located in the muscles, the eyes and the central nervous system, but mostly in the brain. Spinal cord infection is rare. The authors report a case of a young girl, living in Paris who had traveled in Latin America, and complained of back pains and troublesome walking. MRI showed a cyst in spinal cord, but other examinations were normal. Diagnosis was confirmed by a pathologist. It was a pure intramedullary cysticercosis, the check-up to find other locations was negative. Only approximately 130 cases are reported in the literature, with motor and sensory disorders. The diagnosis was based on MRI and pathological examination. Antiparasitic medical treatment was useful when combined with surgery.