Raoultella planticola and urinary tract infection: The first laboratory-confirmed case in an HIV-infected patient in Mali.

Raoultella planticola is a Gram-negative, aerobic, non-motile bacterium, abundant in the environment, but rarely associated with pathology in humans. Notably, few urinary tract infections caused by R. planticola have been reported. To our knowledge, we are presenting here the first case of urinary tract infection caused by R. planticola in an HIV-infected individual. It is a 50-year-old female, with a history of HIV-1 infection treated for three years. At admission, her CD4 count was 70 cells/mL, and the main complaints were severe diarrhea and cough. She was diagnosed and treated for pulmonary tuberculosis (TB) and E. Coli enteritis. Initially, we observed a good evolution. However, on day 21 of hospitalization, she presented with fever and dysuria. Urinalysis revealed the presence of R. planticola with resistance to multiple antibiotics. We also detected that she has an HIV-2 but not HIV-1 infection. After receiving the right regimen, she was confirmed cured of her bacterial infections.

Prospective, long-term study of the effect of cabergoline on valvular status in patients with prolactinoma and idiopathic hyperprolactinemia.

Since the 1990's cabergoline has been the treatment of choice in prolactinoma, as it permits rapid and effective hormonal and tumor control in most cases. Evidence of cardiac valvulopathy was demonstrated in Parkinson's disease patients treated with dopamine agonists. Retrospective studies in prolactinoma patients treated with cabergoline at lower doses did not show such an effect. However, few prospective data with long-term follow-up are available. The aim of this study was to assess the safety of cabergoline regarding cardiac valvular status during prospective follow-up in patients treated for prolactinoma or idiopathic hyperprolactinemia. We report here a series of 100 patients (71F; median age at diagnosis: 41.5 years) treated with cabergoline for endocrine diseases (prolactinoma n = 89, idiopathic hyperprolactinemia n = 11). All patients underwent complete transthoracic echocardiographic studies at baseline and during long-term prospective surveillance using the same equipment and performed by the same technicians. The median interval between baseline and last follow-up echocardiographic studies while on cabergoline was 62.5 months (interquartile range: 34.75-77.0). The median total duration of cabergoline treatment was 124.5 months (interquartile range: 80.75-188.75) and the median cumulative total dose of cabergoline was 277.8 mg (interquartile range : 121.4-437.8 mg) at last follow-up. We found no clinically relevant alterations in cardiac valve function or valvular calcifications with cabergoline treatment. Our data suggest that findings from retrospective analyses are correct and that cabergoline is a safe chronic treatment at the doses used typically in endocrinology.